


Paper Hearts

by NurseBadass



Category: Grey's Anatomy
Genre: F/M, Gen
Language: English
Status: Completed
Published: 2011-12-10
Updated: 2011-12-10
Packaged: 2017-10-27 03:48:25
Rating: Mature
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 30,240
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/291305
Author URL: https://archiveofourown.org/users/NurseBadass/pseuds/NurseBadass
Summary: <blockquote class="userstuff">
              <p>Preston Burke was the best. He went to the best school, snagged the best residency, boasted the best fellowship. Preston Burke was the best. Now? Now he's the biggest disappointment to Cardiothoracic surgery ever and dragging Seattle Grace Hospital's reputation down with him. Boasting a record of more complications, longer post-operative stays and numbers that just don't add up, Burke has put his career and himself on the line. Under pressure from the hospital's medical review board, Dr. Richard Webber must take steps to ensure that his surgical department remains at the top. Webber hires Dr. Cristina Yang, an up and coming, ambitious surgeon from a local rival hospital to investigate exactly what is going on in his ORs.</p><p>(This story is an AU fic loosely based off of the dynamic of The X-Files). Thanks to openended for the amazing beta. This story wouldn't be what it is without her.</p>
            </blockquote>





	Paper Hearts

Life is about being the best.

We go to school, we get awards when we get the best grades, we get medals when we cross the finish line faster than anybody else, we get trophies when we beat all of the other teams. As we continue to grow, those expectations follow us. We make choices; the best college, the best program, the best career. Anything less than the best is unacceptable.

Disgraceful.

The best of the best though, stand out; they make the best look no more than average.

Preston Burke was asked the same question that every prospective medical student was asked during their interview at Johns Hopkins: _why do you want to be a physician?_

Every applicant always gives the same answer: _I want to save lives_ , and that’s how his answer started out. The interview panel, anticipating this answer, began to move on but he held up his hand and retracted his statement. It wasn’t that he wanted to save lives, it was that he wanted to give those already alive a chance. He wanted to heal. He didn’t want to scrape together some drunk that flew out the windshield of his car and give him another day to drink himself to death.

He wanted to be able to tell people that he would give them a fighting chance no matter what they were facing. He swore that day before the admissions panel that his career would not be about statistics, numbers, and awards. His career would be truly about saving lives.

The panel both amused and enamored with his answer, unanimously decided to grant him admission to the prestigious institution.

During his years in medical school, he had lived up to all of their expectations. He was driven and gifted. He worked day and night in the anatomy lab, logging at least twice the hours of his fellow students. While other students in the program used what short breaks were available to them to decompress, he submerged himself completely in the medical sciences, making few friends along the way. Burke accumulated every award and every recognition possible. He graduated first in his class with a staggering fifteen different offers for the top surgical residencies in the nation.

To his instructors, it appeared that Preston Burke was an unstoppable force.

Despite the fact that he had told the truth on the day of his interview, the panel of instructors and administrators had expected more out of him. They had expected awards and prestige, yet another shining star from the school’s renowned program. Such a determined and knowledgeable young man should surely change the face of medicine. Yet, his career had grown to be nothing short of the biggest disappointment in cardiothoracic medicine.

With a slightly higher than average mortality rate and an abnormally high postoperative complication rate compared to most surgeons in his field, it was a conundrum as to why patients and their families raved about him and his lacking surgical skills.

Rather than focusing on advancement of cardiothoracics, his journal articles centered on managing postoperative complications- a taboo in surgical journals. The young man that had once held such hope for the field of medicine had definitely blossomed into nothing more than an average surgeon unworthy of the prestige of the Hopkins education he had received.

Or so it had seemed.

We spend our whole lives being told that we’re supposed to be the best . When you fail to exceed those expectations despite your efforts, the only thing you have left to rely on is instinct and the knowledge that what you’re doing is the right thing.

Even if it’s not obvious to everybody else.

\--

There’s a quiet intensity about him as he scans over the records in front of him. Something calm but angry at the same time, or so Meredith Grey thinks as she studies him.

Truth be told, she probably wouldn’t have come here in the first place if somebody hadn’t referred her to him. He’s renowned and his patients love him but there’s something about him, the way he schedules his appointments. When a friend told him that his methods were unconventional, she shrugged it off thinking that he was just another asshole surgeon. Another surgeon that would tell her that her mother is dying and that there’s nothing he can do.

“Well?” She presses, “Can you do anything?”

Preston Burke looks up from the file and smiles tersely, peering at her through wire rimmed glasses. There’s determination in his eyes that she hasn’t seen in the eyes of the other surgeons that she’s talked with, “It won’t be easy.”

“Yeah, I figured that out when the other three heart surgeons I spoke with turned me down,” Meredith mutters, “that’s not what I’m asking you. I’m asking you to give my mother a chance.”

“You realize that there’s a great risk that she could die during the procedure or soon after?” Burke asks. The words are empty to him. These patients have nothing to face but a long and painful death. Death by surgical complications or even intraoperatively would be a mercy killing compared to what they face.

“With all due respect, my mother is already dying. I don’t think it matters when at this point. The only thing that matters is that she has at least a chance to live.”

Burke gives her a slight nod and closes the file, “I’ll have my nurse get her scheduled. It will be sometime next week. You’ll need to stop all anticoagulation therapy with her. If she starts having chest pains, call this number,” he extends a card bearing only his name and a pager number, “do not contact the hospital and do not bring her to the emergency room. I’ll call back promptly and we’ll get her in sooner.”

“Don’t bring her to the emergency room? Are you sure?” Meredith questions.

“Have they been able to help you yet?” he asks authoritatively.

“No.”

“Alright then,” Burke says, sliding his glasses off, “we’ll contact you when she’s scheduled.”

Meredith takes that as her sign that she’s excused and she leaves the stifling office. Burke waits until she’s gone and exhales heavily. His eyes glance over his already-booked calendar and then up to the clock on the wall. Sleep has been escaping him lately but he knows it’s with good reason.

He wastes little time sorting the details in his mind and tucks the medical records for Ellis Grey into his briefcase. There are lives to be saved and for now, his is of little incident.

\--

Burke walks the hallways of Seattle Grace, the whispers following his footsteps, a quiet roar in his wake. A day rarely goes by in which the story of how he went from being the best resident in the country, as awarded by Harper Avery, to the worst surgeon in Washington seemingly overnight.

The rumors are of no consequence to him.

When he approaches the nurses’ station, the nurse behind the counter who was so furiously speaking only a moment before falls silent and looks up, “Yes, Dr. Burke?”

“I need an OR scheduled for Monday. As early in the morning as possible.”

The nurses pauses to look over the schedule, “Maxon has the heart suite at nine am. Then Miller after.”

“Then I’ll take it at 4:30.”

“In the afternoon?”

“No,” Burke answers idly, flipping through some papers, “in the morning. Let the heart team know please.” He walks away before the nurse can respond but still manages to overhear the remark about notifying the morgue as well.

\--

Of all of the programs available to him upon graduation, Burke felt as if Seattle Grace would be the best suited for his long term career goals. They were a teaching institution, open to new ideas and determined to improve the field. Seattle Grace was the hallmark and when he accepted his residency he was sure that it would be the hospital that allowed him to break the grounds nobody else would.

He quickly learned he was wrong.

\--

“You’re going to help me?”

Burke nods slightly but doesn’t give a solid answer as he glances over the chart, “You have chronic kidney disease.”

The patient is quiet for a moment before answering almost inaudibly, “Yes.”

“You also have diabetes.”

Another mumbled answer. His patient shifts slightly, knows exactly where the string of questions is going to lead. He’s been through it before with another surgeon, “Look, I know what you’re going to say. I know that I have other problems. I was diagnosed with diabetes when I was 6 years old. I was an irresponsible college kid and waited too long to take care of myself and now my kidneys are shot. But, look- I’m only 45 years old. I have kids. I know that you’re not supposed to but please…just give me a chance. I know I can handle this.”

Burke closes the chart and looks down at his patient, “I believe that you can too, Mr. Parker.”

\--

Much like during his medical school education, Burke stuck to the books during residency. He followed each instruction from his resident explicitly and was the natural choice for Chief Resident. Time spent on the clock was utilized to learn the precise technique of his craft. Time spent off the clock was better utilized in the lab to fine tune that technique on cadavers with less than viable vessels and even weaker hearts.

\--

“I have a patient in the cath lab,” the blond woman whispers under her breath, “on renal protection protocol. History of breast and ovarian cancer, four years in remission. I can tell just from the angiogram that her vasculature is shot.”

Burke glances up at Dr. Stevens, “But?”

“But she’s only 52. She’s got a large coronary artery aneurysm…”

“Then why are you here? She should be in the ICU being prepped for surgery.”

Stevens smiles widely, passes the chart to him, “I’ll get right on that, Dr. Burke.”

\--

By the time that he completed his fellowship he had already earned the confidence of the Chief of Surgery, his colleagues, and the medical review board at Seattle Grace Hospital. His name appeared in several publications within his first year of flying solo and more than once he nearly let it get to his head.

Sometimes he thinks it would have been so easy to let it all go. It would have been easy to accept the awards and the praise and pretend that there were people out there that didn’t need him. It would have been so much easier to turn away those who would ruin his statistics and his numbers and to continue to astonish everybody around him.

The only thing it takes is meeting with one patient who has been turned away, one patient whose been given a death sentence because their own bodies have betrayed them, to make him realize that the awards would have never been worth more than what he’s doing.

Worth more than a human life.

\--

“I shouldn’t be surprised that you’ve got another one already, but I am,” Dr. George O’Malley remarks as he thumbs through their schedule, “how emergent is this one? Like cancel-my-date-this-weekend emergent or-“

“A date?” Burke asks, his curiosity sufficiently piqued, “With whom?”

George beams from ear to ear, because he’s not exactly what most would refer to as attractive or a ladies man but for once, he feels like the girl he’s seeing is a real catch, “Olivia.”

“Olivia,” Burke repeats the name as if he’s trying to place the face. He knows that he doesn’t know her and that he probably should. The truth is that he very seldom speaks to the people that he works with unless his patients necessitate it.

He’s a busy man.

“Red hair. She scrubs sometimes but she mostly works in recovery and on the surgical unit,” George explains, “so, this weekend?”

Burke looks at him warily, “Schedule it and tell Addison she’s up.”

“But-“

An eyebrow arches high on his forehead, “You want your date, don’t you?”

George’s voice is shaky at best, “Yeah.”

“Then you can tell Addison she’s on. Mrs. Grey has been waiting long enough for this surgery,” Burke stands up, stretches his back slightly, “and if you want to get back on Addison’s good side, you’ll tell her you already handled the history and physical.”

It’s another three hours at work until eyes aren’t prying and people aren’t asking questions but George isn’t one to turn down an opportunity to keep Addison happy, especially if it means his typically absent social life gets to remain intact, “Yeah. Got it.”

“You’re a good man, O’Malley,” Burke says, setting a hand upon his shoulder for only a second before leaving him in the office to check on his other patients.

\--

The thick thud of a heavy journal disrupts Addison’s train of thought and she looks up, disgruntled at the disturbance. Her eyes narrow momentarily and then she looks back down at the paperwork she’s trying to complete. Some may call it just another failure but Addison knew it was a long shot to begin with.

“You know what that is?” Derek asks, a smug grin painted across his face.

“If you need me to tell you,” Addison answers, annoyed by his presence, “then you probably shouldn’t be practicing medicine.”

“Oh, I can provide you with a fairly sound list of people that shouldn’t be practicing medicine, even physicians in this hospital,” he scoffs and opens his mouth to proceed but Addison stops him.

“Don’t start with me Derek, it’s been a long day and I’m trying to do paperwork so I can go home.”

“It’s always a long day when you work with the notorious Preston Burke,” he quips, “I told you that you should have stuck with your original specialty. But we’re not talking about you. Do you know what that is?”

“A medical journal, Derek. But somehow I suspect that you already knew that.”

Derek crosses his arms and leans casually against the counter, “Actually, this is my first published study. They’re hailing my name in the annals of neurosurgery.”

“If only they knew you,” Addison mumbles, scribbling some more information down from the chart onto her papers.

“Jealous, Addie?“

“Addison,” she corrects him.

“You’d be publishing too if you were actually saving lives.”

Addison looks up at her rival and her eyes flicker with anger, “Speaking of publications, did you read that report in _The Journal of Surgical Sciences_ last month? The one that said forty-five percent of neurosurgical consults are referred to hospice or palliative care programs without surgical intervention. Doesn’t that mean you only save lives about half the time?”

“At least the patients I cut on are patients that I save,” Derek argues, snatching up his journal, “I don’t know why you insist on wasting your career with a second rate surgeon. If you would have stuck with the original plan, if you would have just stayed on neuro with me-“

“Then what?” Addison asks, “Save lives half the time? I don’t think so. I went to medical school to save lives all the time.”

“You’re lucky if you save lives a quarter of the time.”

“Screw you, Derek. You wouldn’t make it in cardiothoracics for a week. The only reason you thrive in neurosurgery is because it’s a gray area. You don’t know what the hell you’re doing. You walk around with a smug grin on your face and hold suction until you think an affected area is gone and then prescribe meds when your patient seizes an hour after surgery. Cardiothoracics takes actual skill.”

“I have skill-“ he begins to argue but she cuts him.

“Derek, unless you have something work related to speak to me about, I have nothing to say to you. At all. Ever,” she looks back down at her work and wondered exactly what it was that she ever saw in Derek Shepherd. Whatever it was, she’s glad that she quit seeing it.

“I’ll never have anything work related to speak to you about because I’m smart enough not to refer my patients to your attending,” Derek sneers.

Addison gathers her papers and stands up, “Good. It means I have to deal with you less. Goodbye, Derek.”

“Dr. Shepherd,” he corrects her curtly but doesn’t stick around for her response; he knows it wouldn’t be a pleasant one.

Addison scowls at his back and walks in the direction of the Fellow’s lounge to finish up her paperwork. Derek doesn’t know anything about what she does and as far as she’s concerned he never will. He’s a surgeon in the truest fashion, and saving lives is the least of his concerns.

\--

George groans, looking at the surgical schedule. Sometimes he wonders why he didn’t just take the residency in San Diego. What he’s doing is bad and he knows it, but it’s good too. It’s why he started working with Burke. The options he presented, the argument he made, it spoke to George in the way that he can’t refuse.

Addison consistently tells him it’s simply because he’s gullible.

“Why can’t we get just one day off? Like, all of us. We could go drink some alcohol. Talk. Do things that don’t involve surgery.”

“Because if we had a day off, I wouldn’t spend it with you,” Addison mutters, glancing over the chart in front of her, “this thing is a mess. Who the hell taught you to write a history and physical.”

“Dr. Bailey,” George defends, “and I’ll be sure to tell her that you said that.”

“I’ll be sure to tell her that you’re completely incapable of carrying out the most basic part of providing medical care and that she needs to review it with you.”

“Look, I did the history and physical. It’s my way of saying thank you for letting me have tomorrow off.”

“It’s Preston’s way of trying to keep me from killing you because I lost my day off,” Addison corrects him, “I’m not a moron.”

“Either way, you could be nice to me. I did it.”

She snaps the folder shut, “You did it wrong. I don’t have to do anything.”

\--

Burke stands in front of the board, examining any empty spots in which he could slip in an emergent surgery this evening. He knows that Addison won’t be happy about it but the patient that Dr. Stevens called up to him a few minutes ago that needs some help. After he identifies a block he calls the ICU with his standard preoperative orders, a specialized set for his service, and sends a text message to Addison.

He glances at the clock and knows he’ll have about thirty minutes before she’ll have the rest of the surgical team assembled. It’s just enough time to get something to eat and recouperate from the afternoon’s failures.

“Preston,” a voice calls from behind him, instantly changing his plans.

“Dr. Webber,” Burke turns to face his Chief of Surgery. Another failure on the books equals another speech about disappointment.

“I heard about your patient this afternoon,” the tone in his voice is less interested in the circumstances and more frustrated about having to discuss this specific set of circumstances again.

“Reluctant heart, Dr. Webber. What can I say?”

“You could start by telling me what second rate cardiologists are sending these patients over so I can have a talk with them.”

“The same as always,” Burke answers, doing his best to pretend as if it frustrates him as well, “her records reflected that she was a prime candidate. Active despite her age, labs were within normal values despite the renal failure secondary to her infarct, no family or personal history of adverse reaction to anesthesia. I had no reason to doubt that she would do well.”

“Cut the crap, Preston. I’ve heard it all before,” Richard says through gritted teeth, “I don’t need your explanations. What I need is your results. We’re expecting CMS to visit next year and I can’t give this program to them without explanation. You were the best, Preston-”

“And I still am.”

“Your numbers don’t reflect that.”

“How many postoperative infections have I had? How many open sternotomies have I had to perform because of careless surgical technique? The numbers are where they should be.”

Webber holds his hand up, having heard enough of the argument. They enjoy the same song and dance quite frequently and he’s found himself at a point of wondering why he even bothers, “They may not be able to trace the unique set of postoperative complications back to you, Preston, but your patient length of stays are greater than anybody else’s. The incidence of renal failure, prolonged extubation, increased need for intensive care, that’s money.”

“Money that’s constantly funneled straight into the department from my former patients,” Burke argues.

“Money that’s not going to make a difference to CMS. They want outcomes. They want decreased length of stays. If you can’t provide that, I’ll find somebody who will.”

Burke knows that it’s an idle threat: he’s heard it a million times before and nothing has changed yet, “Of course. In the meantime, I have an emergent case rolling in from the cath lab. If you’ll excuse me, I have some business to attend to.”

“That business better be getting your department together, Preston. I mean it.”

“Of course, Dr. Webber,” Burke waves, doing his best not to not seem dismissive though he really is. He’s heard it all before and he’ll hear it again.

\--

Addison glances up from the sink when Burke enters the scrub room, “Preston, you had better hope this case doesn’t go like the last one. Did Dr. Stevens tell you how bad-”

“I know how bad,” Burke confirms, interrupting before she’s even finished, “Did Dr. Stevens inform you that she probably wouldn’t make it through the night either way?”

“Yes but we’ve already had two patients this week. You have to push back some of your consults. Webber is getting suspicious and people are starting to talk instead of whisper,” Addison says, “I’m not trying to tell you how to run your department but this is too much, Preston. You’ve done too many this month. We used to limit this and I respect what you’re doing but it’s getting out of hand. We’re going to get caught.”

“You are telling me how to run my department and we’ve had this discussion before. You know how the influx of patients can change from week to week. I’m not concerned and Richard’s idle threats are just that, idle threats,” he pulls a scrub packet from the dispenser and tears it open.

“For how long?”

“You worry too much.”

Addison shakes her head, “And you don’t worry enough. I know that we’re trying to do what’s right but we can’t do anything if we get caught. Webber requested records on half our patients last month.”

“And he got them, reviewed them, and returned them with no questions asked.” His answer is curt and his demeanor signals to her that he’s simply not in the mood to deal with her worries on top of Webber’s questions, “Did Stevens get the echo?”

“Yes. Valves are normal, trileaflet structures.”

“Good,” Burke mumbles, more to himself than to her, “with her left main as diseased as it is, she needs as much help as possible.”

“Left main, right obtuse marginal. Stevens said that the LAD was diffusely diseased but viable with some collateral,” Addison rattles off, “diabetic with a history of chronic kidney disease but she’s never required dialysis.”

Burke raises his hands and shoulders the OR door open, “Let’s try to keep it that way.”

Addison watches Burke disappear in the OR and exhales softly before she follows him. She’s worked with him for several years, but she’s never considered herself a blind follower of his work. She believes in what he’s doing but thinks he should be more careful about it some days, especially the weeks when they’re a little more obvious.

This evening though, she hopes that he proves her wrong. Just one patient pulling through this week without complication, one decent case would bring up her spirit, and hopefully his, and take the edge off.

Induction is without consequence. Intubate, open, separate the ribs, cannulate the aorta, heparinze, initiate bypass. She works carefully to excise the saphenous vein from the upper left leg of the patient and Burke requests a long portion so she continues into the lower leg as well. With the graft procured, Addison is able to return to the head of the table and watch as he delicately assesses the patency of the patient’s vessels.

It will never cease to amaze her how somebody with such large hands can be so graceful and talented, how somebody of his stature can have such a delicate touch. Addison studies each movement and commits it to memory. After this year, she’ll be moving on from his program and into a program where the hearts are much smaller and she can only hope to have hands like his.

Burke instructs her to rotate the heart gingerly as he makes the first incision into the diseased wall of the vessel and bonds the new vessel to the heart. Each movement is precise yet quick, a race against the clock to get his patient off bypass as quickly as possible.

When the patient’s blood is infused back into the heart, Addison smiles inwardly and knows that she got the patient that they so desperately needed to even out their week. The patient will be undetected by the powers that be, but to the people who matter it’s all they need to keep going.

“Dr. Montgomery,” Burke speaks, his voice softer than in the scrub room, “why don’t you decannulate the heart and close? I’ll observe.”

“Of course, Dr. Burke,” Addison answers, nodding to the perfusionist to begin rewarming. She works under his watchful gaze, carefully removing the cross clamp and then the needles, taking the time to place small sutures in the puncture sites and ensure there’s no oozing from the sites, just as he’s taught her.

After a satisfactory job closing, Burke takes over and tells her to scrub out and head home. She knows that he’s going to stay at the hospital until he knows that the patient is recovering well, which likely means that he’ll once again stay through the night.

“I can stay if you need me too,” Addison offers, “I don’t mind.”

“It’s fine,” he says, signing off on orders as the patient is wheeled out of the OR. He waits until it’s empty before he speaks again, “Did O’Malley tell you about Mrs. Grey?”

“He did,” she confirms, pulling off her mask, “I took the history and physical from him. I want to make sure these are done right.”

“O’Malley does a fine job,” Burke defends, though he knows that Addison is more thorough, “it isn’t necessary.”

“It’s my case and it is necessary.”

Burke doesn’t waste the time arguing a point because she’s just doing her job and all that it encompasses and he’s not going to dissuade her otherwise. He scrubs out quickly and leaves her to follow up on his patient.

Addison looks out at the empty OR and the anxiety that she was feeling just a few hours ago has dissipated. She wishes silently that she had the nerves of steel Burke seemingly possesses. It gets like this for her sometimes, where she’s afraid that they’ll be discovered, where she knows that she’s going to lose her teacher and her career but then they have a successful case and the knot in her stomach settles down once more.

Silently she hopes that eventually somebody will realize what they’re doing should be protocol and she won’t have to be nervous ever again.

\--

The glass edifice of Seattle Grace Hospital acts as the perfect mirror as Cristina Yang strides towards the entrance with confidence. Though Seattle Presbyterian has served her well over the past few years, she always knew that the hospital wouldn’t offer the prestige or the longevity that she desired.

Seattle Grace is exactly what she needs to drive her to the top.

Cristina had always considered Seattle Grace to be endgame for her but she had never expected for them to contact her first. The inquiry on their behalf only sweetens the deal for her. It came at an unexpected but very welcome point in her career; just a month ago she was being passed over for the Harper Avery award, not because of lack of surgical skill but because of her hospital, her program, holding her back.

There’s only so much she could do at a private institution. Despite her distaste for residents and medical students, she needs an educational facility to truly excel.

Her heels echo loudly against the tiled floor and throughout the entry of the hospital. She follows the arrows through the lobby that lead her to a small office tucked away under a set of stairs. Stale potpourri wafts through the air and assaults her nose. She resists the urge to wrinkle her nose at the offensive smell before nodding politely to the frumpy receptionist behind the desk and giving her name.

The receptionist asks her to take a seat but she’d rather stand. She studies an exterior photograph of the building as if staring at it long enough will reveal all of the hospital’s secrets and for a moment, loses herself to the thoughts that have been plaguing her since she received the recruitment call. Those thoughts are quickly interrupted by a dignified looking man whom she quickly recognizes.

“Dr. Webber,” Cristina speaks, extending her hand, “Cristina Yang. It’s nice to finally meet you.”

“Likewise, Dr. Yang. I’ve heard many great things about you. It’s a pleasure to put a face to the name,” he agrees, “please come with me. We have a lot to discuss.”

“Yes,” she agrees, walking alongside him.

For the most part, Webber is silent as he leads her towards the elevators and then to his office. Richard Webber is not a man for small talk and Cristina appreciates that; small talk has never been her forte. When they reach his office, he motions for her to take a seat and then he closes the door behind her.

“Water?”

“No thank you,” Cristina refuses, pulling a folder from the briefcase at her side, “I appreciate the opportunity to visit with you today, Dr. Webber. I hope that-”

“Please,” he says, taking a seat, “call me Richard.”

It’s not an informality he offers often. Richard isn’t a fool though and he can tell the woman before him is no-nonsense and the first thing he needs to do is cut the crap before he says anything else.

This catches Cristina off guard, “Of course. Richard,” his name is foreign on her lips and it’s hard to wrap her mind around such informality let alone his reason for extending it.

“Your work is well known to the Seattle area, Dr. Yang. Recognition by Harper Avery, bimonthly journal articles amongst various publications, clinical trials. For a surgeon so young you’ve certainly made your mark in cardiothoracics,” Webber rattles off her many accolades, “and I understand you have a PhD in chemistry?”

Cristina nods and smiles graciously. It never gets tiring hearing how startlingly good she is at her job for somebody her age. When the fact that she’s a woman gets factored in, the praise only grows. Not only has she infiltrated the old boys club, she’s about to dominate it, “Yes, sir. UC Berkeley.”

“A California girl,” Webber chuckles, “I’m afraid I wouldn’t have pegged you as the type.”

She smiles again but she doesn’t answer this time. Cristina isn’t a California girl but explaining that her mother is frivolous and the only city that would ever suit her lifestyle is in southern California would be disclosing far too much information.

“Well, as you know, Dr. Yang, we find your accomplishments and achievements highly intriguing here at Seattle Grace. Can you tell me what you know about the program?”

“I can tell you that your hospital is the pinnacle of surgical residencies. Thousands vie for your positions and you’re one of the only programs in the nation to offer a combined fellowship and residency. Seven years of a grueling program that has turned out several fine surgeons. The cardiothoracic program was once listed as top in the nation,” she falls quiet and avoids mentioning that it’s floundered under the supervision of Preston Burke.

“And what else do you know about the department?” Webber presses, “What you say is in confidence, Dr. Yang. You’ve already impressed me. There’s no reason to be shy.”

“I know that the program isn’t what it once was,” she states, trying to be as objective as possible, “that once Dr. Polin resigned as head of cardio and Dr. Burke took over the program that things have been lackluster, especially for such a prestigious program. Fantastic surgeons still turn out of the fellowships, inexplicably so since the numbers don’t match up.”

“The numbers don’t match up,” he echoes, “are you familiar with Dr. Burke’s work?”

“I am,” Cristina says, “he graduated top of his class from Johns Hopkins. He was recognized as Resident of the Year by Harper Avery. Six years ago, he was the surgeon to beat. Today he’s-” she stops short of calling him the biggest disappointment that cardiothoracics has ever seen, “he’s not what many expected him to be.”

It still disheartens Webber to hear those words, “And that, Dr. Yang, is exactly why I want you to step on board. I cannot offer you a job as department head but I can offer you a salary that you’ll find very attractive and hours that suit your needs.”

“With all due respect sir, surgery is my life. My hours work around surgery, not the other way around.”

“Dedication, I respect that,” Webber notes, “I understand that it would be something of a demotion for you but I can promise you leadership within the next year if you’re able to assist me with an investigation of sorts.”

“Investigation?” Cristina asks, her eyes narrowing ever so slightly.

“As you said, the numbers don’t match up. Our own hospital investigations have turned up no applicable cause to the surgical residents or attendings. There are suspicions as most cases are linked directly to Dr. Burke, however there’s no hard proof. We want our hospital, our program, to be the very best. In order to be the very best we have to have the best numbers, the best surgeons.”

“And Dr. Burke is not the best,” Cristina concludes, “I’m afraid that espionage is not one of the skills listed on my resume, Dr. Webber.”

“I need an experienced set of eyes in my department, Dr. Yang. An excellent set of eyes. I need somebody to identify the fundamental issues with the department and report back to me so those issues can be corrected, whether it’s with the nursing staff or the surgical staff,” Webber pauses to extend a sheet of paper with a lucrative offer on it to Cristina and waits while she looks over it. Her reaction is minimal, just as he suspected it would be, “I think we can make it worth your while.”

Cristina looks up from the offer to Webber, jaw set firmly and gives him the slightest of nods.

It isn’t the ideal situation but Cristina will do whatever it takes to get to the top, including stepping on some second-rate, should have been surgeon.

\--

Cutting ties with Seattle Presbyterian is not difficult for Cristina. From the very beginning she’s been all business. She’s a surgeon and she conducts herself as such: make the necessary introductions, get down to the problem and present the solution. Intervention is sterile and follow up is minimal yet effective. She doesn’t allow things to get messy because that’s when complications arise.

Cristina doesn’t allow for complications.

Nobody questions her decision to leave and she doesn’t need to offer up explanations to anybody. If she were a slightly more frivolous person she would care that nobody seems to be bothered by the fact that she’s leaving. The path to excellence may be a lonely one but she knows it will be well worth it in the end.

\--

George takes another shot at the trashcan, his rumpled up piece of paper bouncing off of the rim before rolling across the floor at Burke’s feet. The man doesn’t bother looking up from the chart that he’s writing in and George silently wonders to himself if the guy has any sense of humor at all.

Burke seems like he could be a fun guy. Sometimes. When he’s not working.

Which is never.

There’s a knock at the door and George calls out, “Nobody in here except Seattle Grace’s most unwanted!”

He shrinks slightly under Burke’s glare, “What? It’s Addison. It’s the seven o’clock meeting.”

Addison enters before Burke has an opportunity to answer George.

“Try a more professional greeting next time,” Addison hisses at George before turning to Burke, “I know that we’re supposed to discuss our cases but Ellis Grey’s daughter is here and she’s wanting to talk to you about her mother’s condition.”

“Of course,” Burke answers, closing the chart, “I was expecting her.”

George watches as Burke pauses to pick up the balled up paper at his feet, “Please attend to the history that I asked you about while we’re gone. We have a lot to discuss.” Effortlessly, he tosses the paper into the basket and leaves George slightly awed and dumbfounded.

“I could have made that shot,” he mumbles to himself, reaching for a chart.

\--

Addison watches from the hallway as Burke offers a curt smile to Meredith Grey as she sits vigil at her mother’s bedside. The woman is experiencing some minor complications secondary to her diabetes but as Preston often says, it’s nothing that he can’t handle. She scribbles down another couple of notes in a chart and closes it, waiting for him to join her.

They’ve got a full day ahead of discharges and follow ups with no actual scheduled surgeries. At the very least that she can relax about that.

Burke leaves his patient and places the chart in Addison’s hands, “She’s doing better than you expected.”

There’s arrogance in his tone that’s unmistakable and Addison smiles to herself. She much prefers when he’s in this mood, the mood that comes along when he’s not under pressure and all of his patients are doing better than expected.

“Blood sugars are high,” she says dryly, “have you consulted medicine to manage her with some Lantus maybe? Something other than the insulin drip?”

“I’m giving her another day,” he says with a shake of his head, “with such a brittle history I wouldn’t expect her to rebound so easily.”

“What about-”

“I’m not concerned with it. She will have already fallen out anyway. I’m sure that Webber will pull her record.”

Addison bites her tongue and reminds herself that he’s been doing this a lot longer than she has. Maybe he’s learned his lessons from being overly aggressive, “It’s a good thing that I reviewed the record. Dr. O’Malley nearly left out a history of diabetes all together.”

Burke glances down in her direction and makes mental note to check the records that O’Malley has handled, “That is a good thing.”

“I’ve already drawn up the discharge papers for 5524 and 5788. Therapy has released both of them and home health is following 5524 for home oxygen needs,” Addison informs him, shuffling around her arm-full of charts.

“And I suppose that the home oxygen will still not dissuade Mrs. Robbins from smoking,” he comments dryly. He takes the chart as Addison hands it over and he flips it open to look over the orders. Robbins was one of his standard cases, not a referral and nothing emergent. He’ll never understand why the system is okay with patients who smoke, one of the greatest risk factors for coronary artery disease in the first place. That same system will refuse patients with idiopathic diseases, patients whose bodies have revolted against them in the worst ways possible.

One day he’ll change those things. He’ll keep doing what he knows is right and he knows that the field will eventually follow suit.

“Have you given any thought to where you’ll practice after you finish with your neonatology rotations next year?” Burke asks, “Are you still considering practicing here?”

Addison shrugs, “I don’t know. I’ve been thinking about it. I like Seattle and the people here are important to me-”

“You don’t have to continue this field.”

“I _do_ have to continue it, Preston and I’m going to. It’s just that I’m not certain I can continue it in Seattle. I’ve been considering the potential of a private practice,” she pauses a minute, “I think that it would be easier.”

“It would,” he agrees, stopping at his office and opening the door, “I’ve given thought to it myself.”

“And?”

“It’s not for me,” he concludes before he closes the door, “what we do here, no matter how unethical people may consider it, is the right thing to do. It gives me greater access to patients and better means to track the outcomes.”

“It also puts you right under a microscope, Preston.”

“I believe we’ve had this discussion before.”

Addison nods slightly, “I know that we have. It’s just that I’m concerned what’s going to happen when I move to neonatology and you’re left with O’Malley.”

“That’s what’s got you in a bind these days,” Burke realizes out loud, “I had wondered. I haven’t seen you this wound up since you first found out.”

“I’m not wound up,” Addison protests, throwing open a chart.

“You are wound up,” he pauses, “and while the concern is appreciated, Addison, it’s not needed. I was doing this for a few years before you got here. Without your assistance or anybody else’s.” Burke leaves out the part where he prefers that way because quite frankly he does. It’s not a matter of liability or possession of his cause; it’s a matter of responsibility. If he goes down trying to change things the last thing he wants to do is take his friends with him.

“I’m still entitled to worry. Not just about the work but about you too,” she tries to explain herself, “all you ever do is work. And right now you have help. What’s going to happen when you don’t? Are you going to give up sleep?”

“As I said, there’s no reason to worry about me,” he assures her and does his best to change the topic, “slow week this week.”

Addison sees right through his motives and decides to drop it for now, “So I’ve noticed.”

“Do you have plans for the weekend?”

“No. I know better than to make any with you.”

“Whatever will you do when you have your weekends back?” He smirks slightly before shuffling through his drawers to find the medical records on his latest completed referrals.

“As of right now, I’m still making no plans. I’m not certain that I’ll truly have them off,” she half teases, half hopes that he’ll understand that she’s making herself available should he need the assistance.

Burke understands but he refuses to accept.

\--

Cristina accepts the new white coat with her name and credentials embroidered on it, offers a curt thanks to the Chief’s assistant when she hands over Cristina’s new access badge. The navy blue scrubs are a drastic contrast to the red scrubs she’s previously worn, though a welcome change.

She sets the scrubs aside and slips on her lab coat over her clothes. There’s no need to change into them as she’s fairly certain she won’t be in surgery today. It’s almost automatic that she tries to clip her badge to the waistband of her pants and curses inwardly when she realizes that it doesn’t work as well with dresses and business casual as well as it does with scrubs. Cristina clips the badge to the lapel of her jacket and looks up just in time to see Webber approaching her.

“Dr. Yang, I see that you’re all squared away. Please, let me show you to your office and introduce you to your new colleagues,” he greets. Richard knows that Burke won’t visibly react in front of Dr. Yang, however he knows that it’s not going to go over well.

He’s hoping that this will perhaps be motivation for his least reliable surgeon to get himself together and do better.

“Good, I’m looking forward to it,” Cristina answers, though she’s doing no such thing. She’s more interested in seeing the inside of the ORs and getting acquainted with the layout of the building on a more personal level than that of brief tour that Webber gave her when she interviewed.

The hospital is just as impressive on the inside as it is on the outside. The equipment is new and up to date. The image in the hospital is just as important as the care and that appeals to Cristina. When they arrive in the surgical department she can feel at least ten different sets of eyes fall on her in curiosity but her resolve does not fade. Webber makes introductions to various people, some important and some that she’s certain she’ll never interact with again. It’s a business thing, making the small people feel like they’re important.

Webber continues to guide her through the unit to Burke’s office and knocks on the frame of the door before stepping inside, “Dr. Burke, if I may have a moment of your time.”

Cristina glances around the office from the outside and finds that it’s fairly unremarkable, much like its occupant. She steps inside when Webber motions for her and though she’s never met Preston Burke face to face, she recognizes him.

“Dr. Burke, this is Dr. Cristina Yang originally from Seattle Presbyterian,” Webber says, stepping out of the way, “she’s graciously decided to join us here at Seattle Grace Hospital.”

Cristina sees the question in Burke’s eyes, the only change in his expression before he takes her hand with a firm grasp, “Dr. Yang,” there’s a restraint of emotion in his voice that’s not lost on her, “it’s such a pleasure to meet you. I’ve heard a lot about your work.”

 _I haven’t heard anything about yours_ , she thinks, “And I’ve heard a lot about you,” she says, “it will be a pleasure to work with you.”

“Yes, I’m sure that it will,” Burke says, sliding his gaze up to Richard, “I’m afraid I haven’t got much time to visit. I have a case coming up from the cath lab that needs emergent surgery.”

“Excellent,” Webber says, “you can let Dr. Yang scrub in with you and get familiar with our heart team.”

Burke opens his mouth to reason that this case isn’t the best time for that but thankfully Cristina interrupts for him, “Actually, sir, I have to be back down to human resources in about twenty minutes. There’s some paperwork that they needed me to complete but the physician liaison was not available.”

“That’s too bad. Dr. Burke, be certain that you get back with Dr. Yang by the end of the day regarding the surgical schedule. You’ll hand over half your cases to her so that she can get to work. I’ll work on the schedule as to who is taking call and accepting new patients.”

“Of course sir,” Burke says, this time the emotion in his tone is unrestrained, “I’d also like an opportunity to speak with you if you don’t mind. As soon as possible,” he adds for good measure though he’s sure that Dr. Webber already knows.

“It will have to wait, Dr. Burke. I need to show Dr. Yang-” before he can finish his sentence his pager goes off and he pulls it from his waist, “Actually, there’s a level one trauma down in the pit. Dr. Burke can you please continue introducing Dr. Yang to the rest of the staff. I need to go handle this,” he pauses to clip his pager back to his waistband, “Dr. Yang, please find me if you need anything. Welcome to Seattle Grace.”

Cristina nods and waits until he’s gone before she looks back to Burke expectantly, “It seems as though he forgot about your surgery.”

“It seems as though he did,” Burke adds, idly sizing up his new competition. He knows her work well, knows of her articles. She is exactly what his department does not need, “You’ll have to forgive me, I wasn’t aware that we were hiring any new attendings in the department.”

It’s not difficult for Cristina to decide how to play her cards. If she’s going to figure this mess out for Webber she can’t make enemies right off the bat, “It was the opportunity of a lifetime,” she answers, “one that I wasn’t willing to pass up.”

“I’m sure that Seattle Presbyterian will miss you.”

“They will but it was a restrictive environment. Private practice is not ideal for advancing the field,” she agrees, “the hospital offers a good program. Opportunity for growth.” Cristina amuses herself with the choice of words and thinks that she may enjoy this for the first few days that she’s waiting for her patient list to grow.

“Growth,” Burke echoes, knowing that she has absolutely no idea what the meaning of the word is. He glances at the clock and knows his patient should be rolling into the OR any time now and she has an appointment. If he can simply stall for a few more minutes he’ll be able to avoid introducing her to Addison or O’Malley.

Especially Addison.

Burke can already imagine Addison’s reaction and he’s not looking forward to it. She was already concerned enough with the end of her fellowship in adult cardiothoracic medicine drawing closer, now she’ll be even more so.

Cristina catches him glancing at the clock and glances at her own watch, “I do need to return to human resources,” she lies, even though it’s a few minutes early, “I assume that you’ll be preoccupied for a while since you have a patient to attend to.”

“I will,” he answers, relieved that she’s seemingly as ready to escape as he is for her to leave, “I’ll be sure to find you later with a patient list.”

“Great, I look forward to it,” she says and it’s probably the first honest thing that she’s said to him in the entirety of their conversation.

Burke looks on as she leaves his office without another word or pleasantry. He sighs, takes a moment to rub his temple and tuck his thoughts neatly away before heading towards the ORs.

\--

“Dammit,” Burke hisses under his mask, assessing one of his anastomoses. While most people would blame Webber’s poor timing for the difficulties he’s struggling with in surgery, Burke is angrier with himself for letting it remain at the forefront of his mind. His work is sloppy and that’s not who he is.

“Retrograde flow. Administer more cardioplegia. Now,” he says, holding his hand out for another needle driver. He’s trying to determine the best course of action for his mistake when the OR door slides open. Burke doesn’t look up, he’s distracted enough as it is, but he does address the uninvited guest, “Whatever you need, it can wait until I’m finished.”

Addison’s voice is firm as she’s helped to gown up by one of the scrub nurses, “I’m here to give you an extra hand.”

“Not necessary,” he answers and it sounds more like a grunt. It’s atypical of him but it’s been an atypical day.

She takes the suction catheter from the resident and excuses her from the OR, leaving just the two of them with the scrub nurses. Addison clears her throat, trying to find the best way to bring up the hospital’s new employee.

“Not now,” Burke stops her before she can even start, “I have this case and I’m fine. There’s no reason for you to be in here, Dr. Montgomery.”

“Preston,” she hisses beneath her mask, “that woman is here for a reason. We need to be more careful, starting right now. So yes, there is reason for me to be in here.”

Burke places another suture along the anastomoses and then asks for antegrade flow to assess the bleeding, “There’s no reason,” he repeats, temporarily pleased when his extra sutures are holding up. He orders for the patient to be rewarmed and takes a moment to walk away from the table and stretch his neck.

Addison joins him on his side of the table as the patient rewarms, keeping her voice low, “Please tell me that you knew about this and that you didn’t tell me.”

It’s not exactly something Burke cares to discuss right now but he doesn’t have much of a choice, “I didn’t know.”

The blood in her veins runs cold and she exhales slowly. There’s no way that they haven’t been caught, “Have you talked to Webber?”

“Not yet,” he answers quietly, “I didn’t have a chance. The patient was wheeling into the OR.”

“He knows,” Addison finally concludes, “he has to know.”

Burke shakes his head, “He doesn’t know. We’ve been discreet.”

“Then why is she here?”

“Best case scenario, he’s trying to improve his numbers. Worst case scenario, I’ll no longer be head of cardiothoracics for Seattle Grace Hospital,” his answer is strangely calm, the complete opposite of what he’s feeling.

“That can’t happen.”

“It obviously cannot be prevented.”

Addison shakes her head, “Say it is numbers, even if that’s the case we can’t keep this up.”

“I’ll keep this up until the hospital tells me that I cannot.”

“So then what do we do?” Addison, “She’ll find out. It will only be a matter of time.”

“Nobody else has found out and I have no reason to believe that she’ll find out. We’re discreet, we’ll continue to be discreet. That and I have a feeling that Dr. Yang is less concerned with others and more concerned with herself. She can take all the in hospital presentations,”

“And we can handle the referrals,” Addison concludes. It’s almost the perfect plan but she’s still uncomfortable with the presence of the other physician, “I’m not working with her.”

“You’ll do what is required of your fellowship,” Burke remands, stepping out of the role of friend and into the role of teacher, “she may not share my perspective but she’s a gifted surgeon. Never refuse the opportunity to learn new techniques.”

Addison makes a sour face at this, less than pleased at the prospect of working with the woman. She’ll simply do her best to stay tied up with Burke’s cases so George will have to pick up that slack. Despite his intentions, Addison feels as if she’s had the best education possible from him and she certainly doesn’t need to learn from the enemy.

\--

“Richard,” Burke says, striding into the Chief of Surgery’s office without so much as prior notice or the courtesy of knocking. Some may consider it intruding; Burke considers it the Golden Rule. Treat others as you’d want to be treated, that’s what his father always taught him.

Seeing as his Chief of Surgery decided to drop an unneeded and unwanted employee in his department, walking into his office without an invitation is warranted.

Webber looks up, displeasure clear in his expression, “Dr. Burke, I wasn’t aware that we were on first name basis.”

“And I wasn’t aware that my department was hiring attending physicians,” every word is enunciated and thinly veiling anger.

“Your department is floundering, Dr. Burke. As Chief of Surgery and the man ultimately responsible for what happens to the surgical department of this hospital, I can do whatever the hell I want, including making sure that there’s a capable surgeon handling cases,” Webber’s voice rises with each syllable, catching the attention of passerby.

“I _am_ capable.”

“Yet you can’t prove that. Your numbers are crap. I can’t go to the medical review board and prove to them that you’re not a liability to this hospital. I can’t let CMS come into this hospital and review our Medicaid and Medicare accreditation when you’re constantly falling out on core measures. I can’t let you continue to run this department so carelessly,” everything he ticks off should wear on Burke’s resolve but it only strengthens the argument for what he’s doing.

“When are you going to realize that when you operate on people who are ill that there are bound to be complications?” Burke argues, “it’s a part of the job.”

“Not your patients. Not patients who are instructed to go home and start medications. The emergent patients are one thing, it’s to be expected. But the consistency between both is concerning. To me, to the medical board and to the people who can take away our certifications.”

Burke clenches his scrub cap in his fist, his jaw firmly set as he stares down the man he once thought he looked up to professionally, “You were once a surgeon. You know what it’s like to care for these patients. The ridiculous restrictions placed on their care-”

“And I also know that those restrictions are there for a reason,” Webber finishes, “You held promise before, Preston. You were the future of this hospital. Go back to that. Do what you can to get back to that.”

“Or what?” Burke asks, testing the peril of the situation.

The answer is exactly what Burke expects from Webber, “Or Dr. Yang can assume your position as Chief of Cardiothoracic Surgery at Seattle Grace Hospital.”

Burke crosses his arms over his chest, still staring down Webber, “This department is mine. Dr. Montgomery, Dr. O’Malley-”

“Have no say in how the department is run. They’ll work for whomever I tell them to work for or they can find another job,” he responds, “I’m giving you a chance to correct this. I’m giving you a chance to set your department straight with the help of Dr. Yang. Her record is impeccable and she can help give you the numbers that you need. I would suggest you figure out what she’s doing differently than you and adopt those policies.”

Burke scoffs and walks out of the office without another word. He knows exactly what it is that the great Dr. Yang does to keep her numbers so pristine and he’s not interested in playing God with other people’s lives.

There are enough people at Seattle Grace willing to do that for him.

\--

Cristina sits at the nurses’ station, working on the chart of a new patient sent up from the ER with traumatic cardiac tamponade obtained in a rather messy MVA. She’s not used to cardiac trauma cases with Seattle Presbyterian being only a level three trauma center but when Burke offered up the case, she gladly took it.

It’s simply another aspect of cardio to put to her resume.

She still doesn’t understand why he would give up such a case and keep a plain CABG. If she had been head of the department, she would have taken the trauma and given the new kid the CABG. Outside of his different management skills, Cristina still hasn’t been able to isolate exactly what it is that he does differently from standard protocol in his patient care that causes his numbers to be so lackluster. It’s only been a few days, she’s sure she’ll find out soon enough though she was certain that she’d see it almost immediately.

For somebody with such a bad reputation, it should be more obvious, or at least Cristina thinks so.

Burke exits the scrub room and she looks up at him in curiosity. She doesn’t really have anything to say to him but she feels like she should. There’s no way she’s going to be able to impress her new boss if she doesn’t have anything to give him.

Small talk, just like espionage, is not a part of her resume. She tucks her chart under her arm and walks over to the board that he’s glancing at. She’s got two other surgeries scheduled that afternoon and though they’re barely complicated cases, Cristina is grateful for the full board.

“Dr. Burke,” she says idly, looking at the anesthesiologist and resident for her surgery. O’Malley. The guy seems to be a bumbling idiot and she’s not certain how he got into such a competitive cardio residency.

“Dr. Yang,” Burke responds, “how was your case? Did the patient pull through?”

“Of course,” Cristina says, nearly offended at the insinuation that the patient wouldn’t, “though I’m not versed in cardiac trauma, I assure you that there’s nothing that will roll through those doors downstairs that I can’t handle, Dr. Burke.”

“Then you’re doing better than I am. I unfortunately have not mastered the skill of never having a patient die. That’s a valuable trait to have as a surgeon.”

“That’s not what I said.”

“That’s certainly what it sounded like,” Burke points out, “though technically you may know how to handle cardiac trauma, whether it be through practice or study, your skills are still no guarantee that the patient will live. I was merely asking if the patient’s trauma was too great to survive the procedure.”

“Patients don’t die on my table. They have no business being in the OR or undergoing general anesthesia if they’re that close to death.”

It’s an answer typical of any surgeon, refusing to operate on the dying. Her answer doesn’t surprise Burke but he withholds his true feelings in his response, “I suppose you’re right.”

“Of course I am.”

Burke can’t help but be taken aback by her answer, “Confident, I see.”

“All surgeons should be,” Cristina replies matter-of-factly, “you completed a surgical residency, a cardiothoracics fellowship. You know what it takes to get through this program.”

“I did,” he agrees, “I suppose that I just have a different approach.”

“So you’re not confident in your work?” Cristina asks, looking up at him in genuine curiosity. She wants to know for herself how somebody that was so highly regarded could fall from grace so quickly. If anything, it will be a lesson to learn by somebody else’s example.

“I am confident in my work. Perhaps confident isn’t the word that I meant,” Burke says, hesitates for only a second and continues, “perhaps the word I was searching for was cocky.”

Cristina’s eyebrows raise and she can’t help but slightly smirk, “Dr. Burke, are you calling me cocky?”

“If the shoe fits,” he answers, an imperceptible smile turning up the corner of his lips. He’s never been one to put new surgeons in their place but she’s already rubbing him the wrong way and her reaction is enough to fuel the fire.

“I assure you that you’re wrong.”

Burke nods, “I’ll have to take your word for it.”

Cristina looks back at the board, “Why are the surgeries scheduled in such wide gaps?” she asks him, changing the topic, “Who needs six hours for a CABG? I understand that rewarming and induction takes times but it makes no sense to waste that much OR time.”

“I wasn’t aware that having too much time was a problem.”

“It’s not. I’m just asking if that’s a standard of practice here or a personal preference.”

Burke gets what she’s trying to say and he ignores it rather than paying any attention at her petty attempts to prove surgical superiority, “You can speak with Debbie if you would prefer your surgeries scheduled differently. She’s in charge of the board.”

“I’ll do that,” Cristina says, “it’s a waste of time. I hate to be anything less than inefficient.”

“One may argue that scheduling too little time and bumping other surgeries because of complications is inefficient. But let me guess, you don’t have complications?”

“Every surgeon has complications, even me.”

“I’m surprised that you haven’t found a way to curb that,” he prods, “seeing as you seem to have mastered everything else.”

“Give me time,” Cristina assures him, glancing at her watch, “all I need is time.”

The words are less pertaining to her and more pertaining to him, even if he doesn’t know it. She says his name in lieu of uttering something excessive like ‘have a good afternoon’ and heads in the direction of the preop area to check in on her next patient. There will be far fewer complications by the time she’s done with this department.

\--

“She’s hot,” George says before stuffing the rest of his sandwich in his mouth, “like not hot, hot because she’s evil but she’s hot.”

Addison makes a disgusted face, picking at the salad in front of her but not really eating anything, “she is not hot and she’s heinous.”

“She’s hot,” George repeats with a grin.

“You’re disgusting and a traitor. I’m telling Preston.”

“Telling me what?” Burke asks, joining the two of them in the new office. Burke’s office is far too close Cristina’s for comfort to discuss their cases so they’ve moved to an abandoned exam room on the fourth floor.

“He’s got a crush on Yang,” Addison says and the words almost taste sour, “thinks she’s hot.”

“She is. Kind of. Maybe,” George stammers, “I mean, it’s not like I’m going to date her.”

“What happened to the nurse?” Burke asks, taking a seat and reaching into a box to pull out a couple of files. The week and weekend are looking to be busy and with him supposedly being off, and he’s not sure how he’s going to work around an excuse for being at the hospital.

“Still dating her,” he answers with a full mouth, “doesn’t mean that I don’t notice hot women.”

“I think you’re crazy,” Addison says with a shake of her head.

“Ask Burke.”

Their eyes immediately go to Burke and he stares down at the file, contemplating whether or not he’ll even acknowledge the question. She may be physically beautiful but her ego gets in the way of everything else. He settles on not answering the question at all considering the company he’s in.

While he and Addison have never been anything more than friends, there was a time that she saw a potential before. She studies him as he avoids answering the question and she knows that there’s no possible way that he’d be attracted to her, not the way that George is going on about. She’s the opposite of everything he’s working so hard for and he couldn’t possibly find that attractive.

“Just drop it, George. Nobody here wants to talk about her,” Addison finally says.

Burke looks up at Addison and their gazes meet, linger for a second and he looks back down at the file in hand, “We need to determine how we’re going to line these patients up. Dr. Yang is on call this weekend. The problem being that if we receive a high risk patient over the weekend, they won’t receive the care they need.”

“Actually,” George interrupts, “why couldn’t we just take those patients off her hands when we come back to work on Monday? When we divide up the left over patient loads, you take the nonsurgical cases, operate anyway.”

“Because she’ll see them on the board,” Addison says, rolling her eyes. Obvious answer.

“No,” Burke says, “O’Malley may be onto something.”

“It’s impossible, Preston. There’s no way that we can operate on patients that she’s already seen. She’ll find out and we’re already at risk as it is,” she argues.

“So what? We’re just going to ignore the high risk patients one weekend out of the month?” George retorts, “We can’t do that.”

“No,” Burke agrees, “we can’t. Which means we need to come up with something better. A means to distract Dr. Yang, to keep her away from those patients.”

“What if we just have Stevens page us?” George suggests.

“She’ll still wonder why we’re in the hospital on the weekend that isn’t ours,” Addison sighs.

“Then we’ll just have to be here,” Burke interjects, looking straight at Addison, “you or I have to be here at all times.”

“What?”

“You can handle these cases,” he says, staring intently at her, “I’ve supervised you on several. I know that you can handle them and you know where to find me if you can’t.”

“Preston, I don’ think that’s-” Addison falls silent when she sees the desperation in his, the desire to make this work.

“I’ll do what I can,” she resigns, “but I don’t think it’s a good long term idea. Especially since I’m not going to be here.”

“It works for now,” Burke agrees, suddenly resentful of added pressure that he’s just placed on her. It’s the exact opposite of what he wanted: placing more responsibility on her but it’s the only thing he can do to make sure that all patients are covered.

“What do we do in the mean time?” Addison asks, “How do we work around all these patients without involving her?”

“We could just give her one,” George offers, “I mean, we have our records. She’d never know the difference.”

Burke and Addison answer in unison with a resounding no, “We’re not tricking her into taking on high risk patient. Dr. Yang is preoccupied with her numbers and we’re not going to interfere with that.”

“Well, if that’s the case, maybe we _should_ give her one,” Addison mutters, flipping through one of the files. Burke gives her a warning glance and she shoots a look back at him, “it was a joke, Preston. Lighten up. I’m beginning to think you could use a weekend off for a change.”

George casts a curious glance in Burke’s direction trying to imagine what he does whenever he’s not at work. It’s hard to imagine him anywhere but at work or doing anything except surgery. He’s pretty sure that he doesn’t have any friends or hobbies. He’s kind of a man obsessed to George, not that it’s a bad thing. Burkes’s hard core.

More than he’ll ever be.

“What I could use is a useful schedule,” Burke says, ignoring George’s expression, “one that’s going to keep Dr. Yang in the dark.”

“And we’ll work one out,” Addison says, sensing that his frustration is rising.

Everything they’ve worked hard to accomplish is at risk and it’s only a matter of time before they’re found out. Trying to cover it now seems futile and if it were simply high risk patients at stake, maybe they wouldn’t be as worried about it. Then it would be just the patients, but the three of them are well aware the consequences of what they’re doing, the impact that it could have on their careers if they’re discovered.

It’s the ever present elephant in the room.

Burke isn’t willing to let it go and they both care too much about their friend to walk away. If they go down, they’re going down together. The go over the schedule and do the best they can to assign times to the surgeries, discuss the histories that they’ll construct and the impending plan of care for their patients.

Addison and George leave before Burke. He takes a moment to sit in silence with a box full of lives that have not been fully lived, lives that are at a great risk of not getting that chance. He slides off his glasses and sets them aside before rubbing his hands over his face. It’s days like this that makes him feel as if it would be easier to walk away from it all. It would be so easy to turn away patients because of factors beyond their control and claw his way to the top without regard for human life.

He sighs softly before replacing his glasses and lifting the box off the floor. Easy is not an option for him and it never has been.

\--

Cristina is nervous as she walks towards Dr. Webber’s office, a feeling that she doesn’t enjoy. Her eyes focus in on her target, a wall of floor to ceiling windows so everybody passing by can bear witness to her failure so early in the game. The nerves only grow stronger.

Her hands are tied and if there’s something she should be doing differently, she’s not certain what it is. Granted there are other things she could do, pull his files, insist on scrubbing in, show up unwelcome, things that are completely obvious and only make her look more like the enemy than she already does.

Before she’s even able to knock on the door, Webber greets her.

“Dr. Yang, please come in. Close the door behind you,” he says without looking up from some papers on the desk. He continues to make notes on the papers until Cristina is seated before him and then he slides the file away, “thank you for coming. I know that you’ve had a busy few days. Your schedule has been rather impressive for a surgeon so new to this facility.”

“It’s not a problem, Chief,” she answers, already painfully uncomfortable, “my schedule isn’t as busy this morning and my follow ups are done for the day.”

“Good, good,” he answers, smiling, “your turnover times are impressive. You’ve already stirred up quite a big commotion in administration.”

Cristina accepts the praise but reserves reaction for later, “I’m just doing my job, Dr.Webber.”

“And you do it exceptionally well.”

“I do my best,” humility has never suited her but she’s good at faking it for the right person. The awkward pause that follows his praise is what makes her shift in her seat and glance at her watch unintentionally. It’s either lost on Webber or he doesn’t comment on it, and she’s hoping it’s the former. Finally she looks back up at him, “I’m working on what you requested,” she finally speaks, “I haven’t gotten any definite answers for you as of yet but I’m still getting settled in, getting to know the ancillary staff.”

Webber nods, “Of course. I had figured that it may take some time to adjust to the new hospital. It’s understandable.”

Another awkward pause causes her to shift again.

“Yeah.”

“As I said, you’re grabbing a lot of attention from the people who matter. Just keep doing what you’re doing Dr. Yang and keep your eyes out for anything suspicious. We want to be the best here at Seattle Grace and you’re going to take us there.”

Cristina likes his words and she nods in agreement, “It will be my honor, sir,” and it’s the truth. There’s nothing she’ll enjoy more than accepting all the glory for putting Seattle Grace on the map for cardiothoracics once more.

It just means that she’ll have to start playing a little bit dirtier.

\--

Despite her intentions to dig up dirt on Burke’s patients through medical records, Cristina finds herself at a loss as she glances over her notes. She’s reviewed over twenty charts so far and nothing adds up.

 _No infections, no medication errors, slightly longer surgeries sporadically, ~~stellar~~ adequate surgical technique._

Cristina pauses for a minute and reviews the notes, trying to think of what she’s missing. Webber has given her all the information, has told her that the patient’s records are clean but she knows that something isn’t adding up somewhere. She sighs and tosses down her pen down.

“He sucks,” she says to herself, “this shouldn’t be that difficult.”

A quick glance at the clock tells her that she’s going to have to resume trying to decide exactly where it doesn’t add up later. She closes her notebook, grabs her pen and patient list and leaves her office to get to work.

She only makes it three steps before she stops, eyes fixated at a name on her rounding list: _Grey, Ellis_. The list hits the floor and she’s digging frantically through her pockets for her notebook when she realizes that she left it on her desk. She runs back into the office, abandoning the list on the ground and flips open her notebook.

“No infections, no medication errors, slightly longer surgeries, adequate technique,” she ticks off to herself and then flips back a few pages to review the common complications. She shakes her head in disbelief and adds to the list that she’s compiled.

 _High risk patients?_ She quickly scribbles down and then adds the name, _Ellis Grey._

Why would Burke be seeing patients that had already been under her care?

Cristina glances at the clock again and decides that if the nurses need her that they can page her. It’s Saturday, nobody is being discharged and nobody needs immediate care. She’s onto something and she refuses to walk away from it now.

\--

The realization that Preston Burke is still a good surgeon, albeit a stupid one, has never crossed Cristina’s mind. As she scans the records of one of his patients, a former patient of hers, she comes to the conclusion that not only does he have talent, he has a serious set to go with that talent.

Altering the medical records of a patient isn’t only stupid, it’s illegal.

Cristina’s first reaction is to run to Webber, but she doesn’t. She can’t. There has to be a reason that he’s doing it, a damn good one at that. Nobody would waste that much talent without good reason. Initially, she thinks that maybe he’s trying to be a hot shot, a show off, in some sort of way trying to prove that he can operate on just anybody without blinking an eye. She drops the idea just as quickly because it wasn’t like he was winning awards for it.

He’s hiding the fact that he’s doing it.

The potential that the patients can conceal their histories is a great one, but the odds of that happening with every patient he’s ever seen is completely improbable. There’s something bigger going on and she’s close to figuring it out.

“Dr. Yang,” the sound of his voice causes her to jump and she scrambles for the mouse, minimizing the record she was reviewing.

“Dr. Burke,” Cristina speaks after taking a millisecond to calm her nerves.

His brow furrows slightly at the reaction but he disregards it, “The nurses on the floor tell me that you didn’t round on our patients until three in the afternoon on Saturday. Care to explain?”

“I’m sorry, I wasn’t aware that I had to answer to you,” Cristina says casually, trying to exit out of the minimized screen. When she realizes that she can’t, she simply turns the computer off by holding down the power button, “and I was tied up. They could have paged me if there was anything emergent.”

“It’s not a matter of emergency on the weekends. There were three patients that could have been transferred to a lower level of acuity,” Burke speaks authoritatively, irritated by her disregard, “they were short staffed with heavy patient loads. It’s our job to round in the mornings and get orders for those patients to go to free up our ICU and the nurses there. More than that, it’s good patient care.”

Cristina stands up in attempt to bring herself up to his level at least a little bit more, “I’m sorry, are you saying that I don’t give good patient care?”

“I’m saying that the patient comes first. Not whatever you were working on, not whatever you found to be more pressing at that moment. These are things that you should be aware of, Dr. Yang,” Burke lectures, fed up with her attitude. Ever since she’s joined this unit, she’s threatened his work, insulted him personally and given at least one of his residents an inferiority complex.

“Oh, I’m very aware of your standards of patient care, Dr. Burke,” she hisses and walks into the copy room behind him. She anticipates that he’ll follow her because she’s walked away from him in a heated discussion before and he always follows. When the door meets its frame harder than structurally intended, Cristina turns to face him, “Ellis Grey.”

“Excuse me?” Burke asks, masking any sort of reaction. In reality, the name causes a pit to form in his stomach. The optimist in him wants to believe that she could simply be bringing up a patient that has another complication, questioning his work once again.

The realist in him knows better.

“Ellis Grey,” Cristina repeats, “length of stay, 45 days. It took her seven days to come off the vent. Chronically on dialysis and hypotensive, requiring vasoactive drips on and off. Has wasted almost two million health care dollars becoming a permanent resident of the ICU. Ellis Grey.”

“Do you have a point, Dr. Yang?” Burke asks, well aware of her case. She was complicated and he expected complications. Her daughter insisted that the surgery be done and he did it, making Meredith fully aware that it was going to be far from an easy road. It isn’t lost on Burke that Cristina fails to mention that Ellis Grey can now walk down the hallway without getting short winded and that the chronic and debilitating chest pain she suffered from the severe ischemia in her heart has resolved.

It’s more important to her that the patient has spent two million dollars.

“She’s not a candidate for open heart surgery, Dr. Burke. At all. She has a history of stage two chronic kidney disease, diabetes mellitus, hypertension, peripheral vascular disease, frequent falls due to orthostasis. I could keep going. I could write a textbook from her history.”

“So you’re familiar with the case, so what?”

“Except, Dr. Burke, I’m not. Because when I reviewed the history and physical on the patient the only history dictated is a history of hypertension and diabetes. There’s no mention made that the patient is on chronic dialysis. The patient reported history reflects the same,” Cristina rattles off, “her record isn’t the one that I know and I know her case well because her daughter asked me to operate, _twice_ , and both times I told her that it wasn’t possible.”

“Clearly you were wrong,” Burke says, turning to leave the room.

“Hey!” Cristina snaps at him, follows on his heels, “I’m not done talking to you.”

Burke ignores her words and continues walking. For the first time he acknowledges to himself that what he’s done, what he is still doing, is truly at jeopardy- including his career and the career of his friends.

He just doesn’t know what he’s going to do about it.

\--

Addison stands on the walkway, her arms crossed as she surveys the scene before her. A grin spreads from ear to ear when she sees Webber stand up, clearly pissed at the occupant of his office. This may have just turned a bad day into a great one.

“You know,” George says, looking from the office to Addison, “you look really evil when you smile. Kind of like Satan.”

“Shut up,” Addison says, batting him away, “I’m enjoying myself. Immensely.”

“You would. You’re such a sadist.”

“I’m not,” she contends and pauses to take a long sip of her hot cocoa, “I just believe in karma and Dr. Yang has had karma coming to her for a long time.”

George looks back in the office and watches as Webber paces for a moment and then turns to face her again, “He does look really pissed. I wonder what she did.”

“Be herself,” Addison mutters, “she hates everybody and everybody hates her. It was only a matter of time. I knew she wouldn’t last.”

Addison was far from sure that she wouldn’t last but seeing the scene unfold before her, she’s comforted by the fact that she was wrong. She’s happier now that it means their project is safe and that nobody is getting fired any time soon. She had enough to worry about with Burke being left alone and George’s sloppiness. She’s more than happy to lose one of her problems, especially if it’s Dr. Yang.

\--

Cristina walks down the hallway as if in a daze.

The word disappointment keeps ringing through her head and she doesn’t like it. She’s never been called a disappointment and she’s not going to be called a disappointment again. Though she felt as if she was onto something, she felt the safe answer was to simply deny knowing anything as of yet.

Admitting that she knew something only to divulge later she was wrong or even slightly inaccurate would only end up in embarrassment, or so she thought.

She knows now that she should have simply told Webber she had a hunch, a clue, anything to make him realize that she was anything but a disappointment or a mistake. She has been working overtime to figure out what was going on in his department and at least a hunch would have been proof of that.

The only thing she did was make herself look stupid.

Burke’s office is empty when she passes it and she glances at the clock, figures that he’s probably still in surgery since a simple bypass takes him all day. She lingers for a moment and settles on going straight to the source for her answers.

The same answers she’ll deliver to Dr. Webber tomorrow morning.

\--

Burke watches as the hall lights flicker off outside his office door and a heavy sigh of relief escapes. It’s the signal that he has the hospital to himself at least for the next few hours. He has a lot of clean up to do, a lot of questions to answer, and he can’t do it with distraction.

He checks his pager once before setting it aside and spins his chair to procure a box from the stack behind him to review records. When he turns back to his desk, Cristina is standing in the doorway with a few files of her own in hand.

Their gazes meet, his as cold as hers, “Now is not a good time, Dr. Yang.”

Ignoring his words, Cristina flips open a file, “Andrew Rice, 53, birthdate May 7, 1958. History of hypertension, reflux, and a broken arm in 1993. Suffered a massive heart attack while raking leaves six months ago. Underwent coronary artery bypass, five vessels. Despite the patient’s unremarkable history, he was incredibly difficult to wean from the ventilator post operatively and underwent tracheostomy and bought a feeding tube before transferring to a long term care facility.”

“Which he was discharged from two months ago,” Burke adds, “do you have a point?”

Cristina pulls another file out from underneath the file that Seattle Grace has, “Andrew Rice, 53, birthdate May 7, 1958. History of small cell carcinoma treated in 1993, discovered after fracturing his arm. Underwent intensive treatment for eight years including chemotherapy and radiation and has been in remission. Subsequently, the patient has suffered from chronic kidney disease, reflux, diabetes and chronic anemia, all secondary to the cancer treatment. Patient had a massive heart attack while raking leaves and taken emergently to Seattle Presbyterian hospital’s cardiac cath lab. Patient was found to have severe three vessel disease, however, due to his chronic conditions and history, the patient was not a candidate for surgery.”

Burke leans back in his chair and folds his fingers behind his head, listening intently as she pulls out another file. “Ellis Grey, 62 year old female patient. I know that you’re well aware of her history here at Seattle Grace.”

“Yes,” he answers in a somber tone, “yes, I am.”

Cristina holds up another file obtained from Seattle Presbyterian, “I think you’re familiar with her history at Seattle Presbyterian as well.”

He pauses to lick his lips before acknowledging the accusation, “Yes.”

His answer catches her off guard and she closes her mouth though she was prepared to argue with him. Cristina watches him intently, trying to process the fact that he’s not even trying to hide it from her. He obviously doesn’t know that she’s talked with Webber several times. Or he does and he simply doesn’t care anymore, “Why?”

Burke stands and carefully replaces the box that he had retrieved only a few minutes ago. He calmly retrieves his jacket, car keys, and cell phone from on top of his desk and he walks towards the door. “Close the door,” he says quietly as he brushes past her.

“What are you-”

“Do you want to know why or not?” He asks.

Cristina lingers for a minute and closes his office door before following him down the hallway, files still in hand. He pauses at her office door, “Leave the files. They don’t need to leave the building.”

“Like you’re one to tell me how medical records should be handled,” she scoffs and walks into her office to leave them. She grabs her keys and momentarily wonders exactly where the hell they’re going but she’s more curious as to what the hell he’s doing- most likely because her job depends upon that curiosity.

They walk out of the hospital in silence, keeping a fair amount of distance between them. He leads her through the parking lot to his car and unlocks the doors. She stands back a few feet from the car, “Where are we going?”

He looks up at her as he pulls open the driver’s side door, “Are you going to get in or not?”

Cristina hesitates and then pulls her door open before sliding in the car, “For the record, Burke, this is a little creepy.”

“The walls have ears,” he states simply before starting the car and pulling out of the parking lot.

The pair ride in silence, Cristina watching out the window as the lights of the city fade away in the side view mirror. She doesn’t question the distance after his explanation. Their colleagues all live within twenty minutes of the hospital, per protocol. Making the drive to a coffee shop thirty minutes north of the city ensures that they’ll have privacy from the people who threaten his career the most.

Predictably so, the shop is practically empty save for one old man sitting in the corner flipping through a book. The teenager with greasy black hair passes their coffee over the counter and returns to her previous position leaning against the counter, cell phone in hand. Indie music, the soundtrack of Seattle, plays overhead and it gives a weird ambiance to the moment. Cristina feels like she’s in some sort of horror movie and she doesn’t like the detour from normal.

They take a seat at a small table in the corner and Burke takes a moment to pull the thick black rimmed glasses from his face and wipe down the lenses, “Why did you become a surgeon?” he asks without looking up at her.

“What?”

“Why did you become a surgeon?” he repeats, holding the glasses up to the light to see if he’s eliminated the annoying spot disrupting his line of vision. Satisfied that it’s gone, he replaces the glasses and tucks the cloth away.

“What is this? Med school?”

Burke looks at her unamused by her answer, though he’s not surprised to discover she’s as much of a pain in the ass outside the hospital as she is inside it.

When it becomes painfully evident that he’s not going answer her, she sighs, “I wanted to save lives.” The answer is cliché but she’s not in the mood to go into the long answer.

“And do you?”

Cristina smirks, “I think you’re well aware of that.”

“So, the answer is no then,” he concludes before lifting his coffee cup to his lips.

“Excuse me?”

“You don’t save lives,” Burke elaborates, “you pick and choose the people who you operate on. You spend your time concerned with numbers and statistics and less time concerned about the quality of life after your outcomes no longer matter. You may save a life from time to time, traumas, patients who may die eventually without surgical intervention but only through a series of qualifications and stipulations.”

“There’s a reason that we follow those qualifications and stipulations.”

“Why?”

“Because. Operating on patients who are high risk leads to greater complications, longer hospital stays, more healthcare dollars spent,” Cristina rattles off, still not following his point.

“So you didn’t go to medical school to save lives,” he says, “you went to medical school to save a hospital a couple dollars.”

“What kind of quality of life is sitting in a hospital for 45 days?” She counters.

“And what kind of quality of life is spending the rest of your life wondering when the inevitable is going to happen?” Burke asks.

“I suppose that it isn’t,” her voice is soft, a concession of sorts, but not fully, “it’s beyond our control though. There are regulations for a reason.”

“Is there any good reason to send a middle aged man home to die, Cristina?” Her first name feels awkward on his lips, but now is not a time for formalities, “You know the symptoms of heart failure, shortness of air, renal failure, fatigue, fluid retention-”

“Spare me the medical school review, Burke. I know what congestive heart failure does to the human body,” she sighs, leaning back in her chair and crossing her arms.

“But do you know what it does to the human spirit? To that man’s family? I watched my father die because even the best surgeons in the country refused to touch him. He battled and beat prostate cancer, because of the modern miracle of medicine. When he had a heart attack, the surgeons told him that the radiation treatments he received had left him in such a state that he was not a surgical candidate. They sent him home with medications to manage his blood pressure, diuretics that kept him up all night to try to manage the fluid retention, and a death sentence. Because of the same medicine that saved my father’s life, I had to watch my father deteriorate and die a slow and painful death over a period of _years_. Why? Because some surgeon wasn’t willing to give him a chance, because some surgeon wanted to protect his track record,” Burke levels his gaze on hers, “You didn’t go to medical school to save lives. _I_ went to medical school to save lives.”

Cristina fights for words, his explanation affecting her more than she would prefer. She can see the pain in his eyes and it may not be a pain she’s _completely_ familiar with, but she can’t just consider him stupid or incompetent anymore. Not when she knows that his intentions are so ridiculously noble, “Look, Preston-”

“Burke,” he corrects her, “I…Nobody really calls me Preston. It’s Burke.”

“Burke,” she repeats, “there has to be a better way to do what you’re trying to do. Proper channels.” Cristina knows the approval of getting something so high risk approved by any hospital review board is not just unlikely, it’s almost impossible. “What about your career?” She asks weakly.

“My career is not more valuable than a human life,” he says evenly, “there’s always going to be a cost to what I’m doing, whether it’s health care dollars or human lives. We both know which one is more valuable.”

\--

Cristina paces back and forth in her office, a patient’s file in hand. It’s the first rejection she’s had since she spoke with Burke and for some reason she’s struggling with it. His words echo in her head, nag at her ability to simply walk into the room and tell the patient that she’s not a surgical candidate. Suddenly the promises that they’ll manage the symptoms with medications seem empty. Not when she knows that there’s a chance that they could get better, even if it is a struggle.

What she’s contemplating though, it could cost more than this job, it could cost her entire career, everything she’s worked for. Her career may not be worth the price of a human life, but it’s her life and the only one she knows. She’s worked for years for this job, to be where she is now.

For countless minutes she battles with herself about what to do, how to approach it, and bargains with herself, the culmination of which ends up with her standing in Burke’s office, door firmly closed behind her.

“I need your help,” she says quietly.

“Okay,” Burke is caught off guard by her demeanor, how somber she is. It’s a stark contrast to the egotistical surgeon he’s become accustomed to.

“I,” she pauses for a moment, “I have a patient.” Cristina knows that she should elaborate on what that means but she hopes that he’ll just know because saying it out loud really does incriminate her and she’s still trying to come to grips with the fact that she’s even considering what she’s considering.

Fortunately, he understands what she’s talking about and holds his hand out for the chart, “I’ll take care of it.”

“Excuse me?” She says, “I don’t think so. This is my patient. I just said I needed your help. I didn’t say that I wanted you to take over.”

This is the Dr. Yang that he’s used to: somewhat offensive, cocky, and very territorial. Typically it’s off putting but today he’s bemused by it, “And what of your statistics?”

“One case isn’t going to make a difference,” she shrugs it off.

“You think you’re only going to do it once?” he asks, “It runs a lot deeper than that, Dr. Yang.”

“I didn’t ask for a lecture,” she said, already desperately trying to ignore the implications of the facts that she’s even asking for his help, “I asked for your help. Now are you going to do this or not?”

“Of course,” he answers without hesitation, “how emergent is the case? Does the patient need to go to surgery now or can they wait?”

“Her heart is a disaster but she’s not requiring any meds yet. I have her in ICU as a precautionary measure,” Cristina explains, sliding the chart over, “longstanding history of juvenile diabetes, chronic kidney disease and peripheral vascular disease. She’s not a chronic dialysis patient but she’s required dialysis for a bout of renal failure two years ago while battling an infected wound on her foot.”

“You’ve already dictated her history and physical?” Burke questions.

“No,” she says, her stomach starting to churn. This is illegal. This is so illegal and it’s something that she’s going to do, “but the ICU nurse has already entered it into the computer.”

“Then she’s an emergent case,” he concludes and reaches for the phone. He asks for an OR to be opened immediately for Mrs. Beyer and then proceeds to call in the heart team for an emergent procedure. After he’s procured the necessary equipment and people, Burke places the phone in its cradle and turns back to Cristina.

“Head up to the ICU. Order dobutamine and Lasix. Put an order for levophed on the chart as well, even if the patient doesn’t have low blood pressure,” he instructs her.

“You mean neosynephrine,” she says, “levophed is a horrible drug. I can’t believe you still use it.”

“It’s better than the massive doses of neosynephrine you put your patient on to manage a slightly lower than average blood pressure,” Burke says, hiding a smile. He’s never had anybody disagree with his choice of medications.

“Sure. If you’re trying to kill the patient, which I’m sure that you’ve made clear that you’re not.”

“Regardless, go write your orders, tell them the patient is going for surgery and meet me back in the scrub room in thirty minutes. I’ll handle the rest.”

Cristina takes her chart back from him and walks away wordlessly. Her heart is beating rapidly and she thinks that she must look completely obvious to the people around her, as if everybody knows that she’s doing something very, very wrong.

It’s only going to be a matter of time before she gets caught.

\--

“I can’t-” Cristina says, still smiling from ear to ear, “I can’t believe that. I can’t believe I did that.”

Burke smiles at her reaction, the enthusiasm glowing in her expression. It’s what he least expected from her but he enjoys it nonetheless, “You did that.”

“Have you ever seen that before? I mean, her heart was _destroyed_ , and we put her on bypass and reperfused and when we took her off it was like new. I’ve had patients who have gotten better, heart muscle that has pinked up but-” Cristina shakes her head in disbelief, “her heart was dead.”

“And now it’s not,” Burke says softly, pushing her drink towards her, “congratulations, Dr. Yang. You saved a life today.”

Cristina’s smile grows wider if it’s even possible and she lifts her glass to her lips. There have been precious few times that she’s experienced such exhilaration from surgery and she’s not certain it’s ever been like this, “Is it always like this for you?” She asks, “Do you always get this high?”

“Always,” Burke answers, raising his glass in her direction, “To saving lives?”

Her glass meets his with a resounding clink and she agrees, “To saving lives.”

\--

Cristina sits at her desk, studying the call schedule for the next week and trying to work out some open slots for emergency cases if necessary. She’s not giving in to doing cases all the time, but if something truly necessary comes through the doors, she’ll consider it. Or at least refer the patient to Burke. It’s not like he wouldn’t do it.

She’s just not as comfortable adjusting things like he is.

A knock on her door draws her attention upward and she sees Dr. Webber standing in her doorway. She slides the schedule aside and stands up immediately, “Dr. Webber,” she says, “what can I do for you?”

Webber approaches her desk slowly and lowers his voice, “I think that you know exactly what you can do for me, Dr. Yang. The question is have you done it?”

Cristina’s gaze shifts from Webber down to her desk and then back up, “I’m researching it, sir. There are no deviations from the standards of practice that I’ve seen. No infections, no-”

“Dr. Yang,” he interrupts, his voice rising with her name and then falling again. “I didn’t pay you to be Dr. Burke’s mouthpiece. I paid you to find out the truth of what’s going on in this department. I can’t take your excuses to the board. I can’t justify your position and your salary to the medical review board if you’re not doing the job you were hired to do. Are we clear?”

“Are you saying…” Cristina trails off, knowing exactly what he’s saying.

“Dr. Yang, if you can’t produce results, I’m afraid that I won’t be able to defend your position to the medical review board. You will be terminated from Seattle Grace Hospital.”

The words kill her. This isn’t the kind of treatment she’s used to and she knows that she’s in over her head, in more than one way. She simply gives a nod as she watches Webber walk out of her office. She catches Addison’s eye, standing just outside her office door and Cristina looks away, back to her schedule.

Uninvited, Addison enters Cristina’s office, “You seem to talk to Dr. Webber a lot.”

Cristina jerks her head upwards and looks at the one person in the hospital who seems to be still against her, no matter what she does, “He’s the Chief of Surgery,” Cristina mutters, tucking the schedule away.

“Yes, I’m aware,” Addison says, arms crossed, “what I’m not sure of though, is what you could possibly have to say to him so frequently.”

“It’s none of your business what I say to the Chief of Surgery.”

“It is if it’s about this department, about Preston.”

Cristina studies the woman for a minute, remembering what Burke had said about nobody ever calling him Preston. She had suspected there was something more between the two of them but she wasn’t certain of it until now. For some reason, it bothers her, “As I said before, it’s none of your business. Now please get out of my office. I have work to do.”

Addison stares at her coldly. She knew that the woman was bad news from the start and that ignoring Preston’s requests to be civil to her were completely justified. She turns out of the office and pulls out her phone to text Preston.

She has a lot to tell him.

\--

Cristina pulls open the door with a twenty dollar bill in hand, fully prepared to pay the delivery man for Chinese food and her eyes widen slightly when the guest at her door is Burke instead. She immediately crosses her arms over her chest, feeling immensely naked wearing just a tank top and a pair of sweatpants in front of her colleague, “Burke, what are you doing here?”

“What are you doing?” He retorts, “I thought we had an understanding. I thought that we were-”

“Wait, wait…what are you talking about?”

“You know _exactly_ what I’m talking about,” Burke explains, “Addison told me about Webber. Your little conversations with him. I should have-”

“Burke,” she sighs, realizing that she should have known that Addison was going to go to him, “come in.”

“I’d rather not.”

“No, I’m serious. Come in. Let me explain this to you,” Cristina says, trying to keep her voice low, “it’s complicated. It’s not what you think it is.”

“Then what is it?” He presses.

She pulls the door open wider and stands back, “Come in and I’ll answer everything you want to know.”

Burke reluctantly steps into the apartment, hands jammed angrily into the pockets of his jacket. He should have known better than to trust her and tell her the truth. He had mistakenly trusted her each time she didn’t go running to Webber immediately with the information that she’d found, he’d trusted her even more when she brought a patient to him.

Now he knows he was wrong.

Cristina starts to close the door but her food comes and she quickly pays the delivery boy and shoos him off. She abandons the food on the counter, reaches into her refrigerator for two beers and extends one to him, “You may need this.”

Without hesitation he takes the beer from her and twists it open. He’s certain that she’s right, “Thank you,” he says, though he doesn’t feel like pleasantries are deserved right now.

“Look, I know what you’re thinking. And if I were you, I’d think it too. But you’re wrong. Just, don’t close yourself off and don’t get up and leave until I’m done, okay?” Cristina asks, “Give me a chance. I gave you one.”

“I’m here, aren’t I?”

“I’m half expecting you to walk out when I tell you why I was hired,” she mutters, placing herself in the chair that’s situated between him and the door, “there wasn’t an opening. Webber made a position for me and he recruited me.”

Cristina sees his jaw tense and she sighs, “Look, he wanted to me figure out what was going on in the department. Why your numbers suck so much. And he’s been after me and onto me and asking me why I haven’t told him anything. I keep telling him that I’m working on it, and at first I was. I’m not now though. Addison just saw him in my office and jumped to conclusions and they’re not right.”

“Really?” Burke asks in disbelief, “Then why are you still here? Why even bother? You have to give him an answer eventually. Even if you don’t produce an answer, you know that my job is at stake. If you’re not after something, then why would you bother staying?”

“Because you’re-” Cristina stops and tries to gather her thoughts that are moving at a million miles an hour, “what you’re doing is good. But you’re doing it wrong. You work in an educational facility. You don’t have to falsify medical records and operate in such a secretive manner. “

“Obviously I do when Webber has hired you to report me,” he objects before taking a long drink of his beer.

“I think that I have a way to get around all of that, though.”

“Not to be blunt, but why do you even care? A few weeks ago you were obsessed with numbers and statistics. Why waste the time trying to save something that you don’t believe in?”

The label of her beer bottle shreds between her fingers and she averts his gaze, “You’re not the only one with a dead dad, y’know,” she mumbles, “my dad didn’t die slowly. It was quick. Unexpected. But he was the reason that I became a doctor, to save lives. And I started out idealistic, I did. But I was good at what I did, and there were awards and recognition and perks and I lost sight of that, of him. I did it for the awards. I can’t claim that I don’t want the awards, because I do. But what you told me just made me think. It made me realize that I’m not always doing this for the right reasons.”

Burke takes in her words, mulls on them in silence for a few moments, “So you want to make what we’re doing public knowledge,” he finally speaks, “how?’

Cristina looks up, thankful that he’s hearing her out, “Got anywhere else that you need to be?”

His brow furrows and he shakes his head, curious as to what she’s up to.

She smiles as she stands up, “Good, hold that thought. I’m going to get my computer and you can help me eat this food. We’ve got a long evening ahead of us.”

\--

There’s a hint of pride that Burke feels when he pulls the old records of all the high risk patients he’s operated on during his tenure at Seattle Grace. While some of the cases didn’t turn out well, many of the cases are happy endings: patients who are able to return home to their families, who are able to return to a higher level of functioning than where they were at preoperatively.

It’s the first time he’s truly allowed himself to stand back and objectively see exactly how much he has done as a surgeon.

Addison appears in his office with the rest of the records he requested and kicks the door closed behind her, “Shouldn’t George be here for this?”

“Be here for what?” Burke asks, taking the records.

“Aren’t we working on our stories? Trying to figure out what we’re going to tell the Chief?” She elaborates, “Why else would you want all of these records?”

“To tell Webber. Eventually.”

“Eventually? What the hell are you talking about? What aren’t you telling me, Preston?” Addison questions, suspicious of his mysterious demeanor.

“It’s nothing. Research.”

“Research,” she repeats slowly, looking at the piles of records, “so what happened between you and Dr. Yang? Did she tell you why she was speaking to Webber?”

“Because Webber hired her to keep an eye on me,” Burke answers like it isn’t a career threatening revelation, and though he knows it really isn’t, Addison does not. Her reaction is expected.

“And you’ve got all of these records out? What the hell are you doing? Trying to give her material to work with?”

He smirks and then chuckles slightly, enjoying the fact that he knows her so well. The look on her face causes him to laugh a little bit more and he shakes his head, “I’m sorry, I couldn’t resist.”

“I’m trying to understand what you think is funny. There’s nothing funny about this at all, Preston. She’s going to get us all fired.”

“Actually,” he corrects her, “she and I are working on a plan to be more forthcoming with the work while preserving it.”

“What, you’re _working_ with her?”

“Yes. Is there something wrong with that?”

Addison stares at him in disbelief. Yang is clearly the enemy and now he’s working with her like it’s no big deal. “Are you sure that you can trust her?”

He stops shuffling through the records and looks up at his dear friend, “Addison, I assure you that I know what I’m doing and so does Cristina. I trust her. I have reason to.”

“Really? And what is that reason?”

“You’ll see,” his answer is dismissive and Addison’s slightly offended by the fact that he waves her off so easily but he gives her little time to reply, “I need you and O’Malley to really step it up. I won’t be able to be at the hospital as much while I’m working on this so I need you to keep an eye on our patients and I need you to keep an eye on O’Malley’s work,” he says, “I know that you can handle it.”

“I can. I’d rather do it if you’re not leaving me in the dark though,” she says slowly.

“You won’t be in the dark for long, Addison. I promise,” he says, lifting the two boxes in his arms, “I have to run these downstairs. Do you need anything else?

“A better explanation.”

Burke smiles faintly, “Soon,” he promises and walks out of his office, “lock up for me, okay?”

Addison looks at him with arms crossed over her chest as he walks away. She’s not sure what’s gotten into him but she’s positive that she doesn’t like it. There’s an urge to call after him that she’s going to leave his office door wide open but she doesn’t. Instead she glares at his back until he’s out of sight and then closes the door.

\--

Surrounded by piles of paperwork, Cristina eyes her beer across the room, mocking her from the coffee table and then looks back down, “Why did we decide to use the floor again?” she asks.

“Have you seen the size of your table?” Burke asks with an arched eyebrow.

“Shut up,” she mutters, trying to tiptoe around the various piles towards the coffee table. “If I fall and break my neck, you’re going to have a hell of a time talking Addison into doing all of this. Just so you know.”

“I could have gotten that for you if you asked.”

“You could have offered when you figured out what I was going for since I’m being all generous and helping you do this analysis. I could just make you do it by yourself,” she points out before taking a swig of her beer.

“Not likely, then you wouldn’t be getting published,” Burke says with a knowing grin playing on his lips, “your sudden change of heart doesn’t mean that you still don’t want the recognition. Actually, I’m still considering the fact that it’s the only reason you’re helping me.”

“You realize that you’re down there and I’m up here, which means I could easily kick you in the head,” she says bluntly before tip toeing her way back to her pile of papers.

“And yet you didn’t do it,” he says, once her ass is planted safely on the ground.

“Yet.”

“I’m confident that you won’t do it.”

“Then you don’t know me very well,” she mutters, sorting out some more records, “I’ve been working on that STS database paper work all day, my beer is across the room that looks like a dead tree exploded in it and my butt hurts from sitting on the floor. I’m just waiting for you to give me a reason.”

Burke cocks his head to the side for a minute and studies her while she shuffles through the papers in an exaggerated manner. O’Malley was right about her being ‘hot’ in a way, at least when she’s frustrated. The ego leaves little to be desired but he wonders how much of that is real and how much of that is a façade.

\--

Things have definitely not been going as planned and it’s unsettling to Webber that his plan to iron out his cardio department has gone awry. Dr. Yang was recommended as being a strict professional with the utmost respect for authority and she’s proved to be anything but.

Though he’s unsure of how it happened, it seems as though Yang has come to defend Burke rather than uncover his discretions as she had been hired to do. Despite his hollow threats to terminate her position, though the board would never authorize such termination without ground, Yang has continued to directly disobey him and effectively left his hands tied.

“Dr. Yang is here to see you,” Patricia announces from the door and waits until Webber waves his hand to send her in. Cristina walks in, her eye cast downward to avoid his.

Webber watches as she takes a seat and then he clears my throat, “Dr. Yang,” he starts, “when I hired you to work here, I had hoped that you would take my request seriously. However, it seems that you haven’t. Despite my numerous requests to uncover exactly what is happening in my cardio department, you seem intent on doing other things.”

“Sir, I know that I haven’t provided any answers for you yet but I’m still-”

“I was not done speaking,” Webber stops her, every word enunciated and punctuated by anger, “the board is requesting immediate remand.”

Cristina knows that he’s already pissed off and that interrupting him isn’t the greatest idea but she does it anyway, “Sir, I know that you’re getting impatient and rightfully so but if you could just bear with me. I’m in the middle of some data analysis that I think will prove very helpful and-”

“Did I indicate to you that I was done?”

“No, sir,” she immediately says and falls quiet again. She’s going to lose her job before they have a chance to work through their plan.

“Your lack of information has left us with no choice but to terminate Dr. Burke’s position,” Webber says through gritted teeth, “and I’m finding it difficult to isolate a reason to keep you since you’re unable to follow simple instructions.” Though his words are for the most part untrue, he hopes that his threat will motivate the woman before him to disclose whatever information she’s hiding.

Silence lingers between the two of them for a long period of time and Cristina chances pissing her boss off just a little bit more, “Can I speak now?”

“What do you think I’m waiting for, Yang?”

“I’m working on some data analysis. I need time though. There are numerous patients and I’m going through everything with a fine tooth comb. I want to make sure that I have an accurate account of what’s going on in the department. I’m not even sure that I’m correct yet. I didn’t want to provide you with inaccurate data but I assure you that I’m working on it,” she rattles off, silently hoping that it works.

“While that’s all well and good, Dr. Yang, you’ve seem to have gotten to be fast friends with Dr. Burke,” Webber says doubtfully, “I have reason to believe that you’re covering for him.”

“With all due respect sir, I believe there’s an old parable that states that you should keep your friends close and keep your enemies closer,” she counters.

“You really expect me to believe that?” Webber asks.

Cristina focuses her gaze on his, “I don’t believe that you have any reason not to, sir. As you know from my prior references, I’m a professional. I’m here to work, not to make friends.”

“You have two weeks, Dr. Yang. I want information and I want definite information. Do not give me any more of this crap about analysis, don’t feed me anymore of Dr. Burke’s excuses or you’ll both be looking for new jobs.”

\--

Burke smiles widely as he looks at the front page of the Annals of Cardiothoracic Surgery. When they submitted the article, he was confident that it would see print. He never stopped to think, however, that their names would end up on the cover of the journal. He tucks the journal under his arm and flips off the light in his office.

Excitement fuels his step as he makes his way to Cristina’s office and walks inside without knocking, “Get your stuff. We have to go.”

Cristina looks up from her computer, obviously exhausted from the hours of research that they’ve been putting in, “What? Where are we going? I still have this-” she stops talking when Burke holds up the journal, “is that it?”

He nods, holding it out for only a second before it’s out of his hands and in hers, “They published us on the cover? Holy crap, they published us on the cover.”

“We should celebrate,” Burke says, “we have to celebrate. This is big. It’s huge.” For the first time he thinks that their plan may actually work and it’s worth enjoying the small moments. Things may not remain this easy and he wants to enjoy it while he can.

“No, we have to finish this analysis,” she argues, “we’ll celebrate when we’re done. And by done, I mean when everything is done. We can’t just celebrate the small victories.”

“Do you have to take the fun out of everything?” He smirks, “at the very least, let me buy you dinner. We’ll get some take out Chinese and get the rest finished tonight.”

She eyes him warily before she gives him a simple nod, “Fine. But we’re not getting distracted, we have work to get done. I mean it.”

“Since when have we ever gotten distracted, Dr. Yang?”

Cristina can hear that thinly veiled tone of suggestion and she’s not exactly sure what it’s suggesting but it sends a slight shiver down her spine. She slaps the journal against his chest, “Don’t ‘Dr. Yang’ me.”

Burke chuckles and takes the journal back, watching with amusement while she gathers her things. He can’t take his eyes off of her, no matter how hard he tries. Burke blames it on a combination of things, the fact that she’s trying to make what he’s doing much easier than it has been, the fact that they just got published. When she catches him staring, her gaze lingers for a moment and she smiles faintly before looking away again to finish gathering her things.

“I’m, uh, going to go ahead and go get our food. You want your normal?” He asks, suddenly feeling as if he’s lost his cool. Momentarily, he wonders if he’s as obvious as he feels.

“Yeah. The usual. Do you want me to stop and get some beer?” She offers, slinging her bag over her shoulder.

“No, I have some left from the last time, I think. It should be enough.”

“Alright, if you’re sure. We run out before we’re done working and you’re going to get more,” Cristina answers, flipping off her desk light and walking across the office to him, “I’m ready to go now. Why don’t you just call ahead and have them deliver it? I don’t want to wait forever.”

“Oh, here,” Burke says, struggling with his key ring one moment and then extending a key to her the next, “let yourself in. I have a place that I like. They don’t deliver.”

Cristina takes the key without a second thought and they walk down the hallway together. It isn’t until she’s sitting in her car alone that she realizes what that could have looked like if Webber had been standing around somewhere.

Or Addison.

She lets out a heavy sigh and realizes that she has to stop thinking the way she is. It’s exhaustion and staring at her computer screen for too many hours a day on top of an already rigorous surgery schedule. There’s obviously some form of attraction there on her part. He’s intelligent, good looking, and immensely talented.

It’s professional admiration, or that’s what she’s going to keep telling herself.

\--

“You’re publishing together, Preston?” Addison asks, looking up from the journal to her friend. The smile on his face, however imperceptible to people who don’t know him, tells her everything that she needs to know and didn’t want to. “What exactly are you two doing?”

“You’ll see,” he answers, taking back the article. Her reaction leaves little to be desired.

“Don’t give me that crap,” she snaps at him, almost seems surprised at her own words and then reels it back a bit, “you realize that I’ve been here forever? I’m the one who caught you in the act six years ago and didn’t report you then. I’ve cleaned up your work, I’ve had your back. And what? This woman that you barely know suddenly prescribes to your way of thinking and now you’re falling all over yourself to do whatever she’s come up with. It’s not smart, Preston. You shouldn’t trust her.”

It’s not that she’s jealous of Cristina, she hasn’t seen him in that light for ages, but she’s angry that he’s so careless with something so important to him, “It’s like you’ve forgotten what Webber hired her for.”

Burke drops the article on his desk and then turns back to look at her, “Do you remember when you assisted me for the first time?”

Addison will never forget. “Yeah,” she says, “the HLHS case, Madeline. Dr. Evans wasn’t going to touch her, just let her die.”

“And we took her to surgery at two in the morning. I knew when you saw how she recovered, no matter how long the process, that you understood. The same applies to Cristina. She’s come to me with patients, Addison. We’ve shared cases. I know that she understands and while her intentions aren’t exactly the same as mine, she wants to help. We need her intentions if we’re going to make this work,” his voice is soft but urgent at the same time.

“And what exactly is her methodology? Drawing attention from all the wrong people by publishing articles?”

“Or from the right people.”

“Attention at all is-”

“Something that we need if we’re going to be able to continue our work. If we can find a channel to legally do this, without hiding our intentions, without having our numbers lumped into those who care about statistics more than they do the human life, we need this attention,” Burke explains, “I’m sorry that I haven’t been forthcoming with you. It was not my intention.”

“It’s fine, Preston. Just don’t leave me out of the loop. And you can buy me coffee since you left me out of the loop,” she adds with the slightest hint of a smile.

“That I can do,” he agrees, “I haven’t gotten much sleep. We’ve been up all night working on these articles and compiling data.”

Addison looks at him doubtfully, “Oh, so that’s what you call it these days?”

“Excuse me?”

“All night data compilation? I’m not oblivious Preston.”

Burke’s brow furrows until he finally understands what she’s saying and then he laughs a little, slightly embarrassed by the notion yet slightly intrigued all at the same time, “Oh no. We’re not-” he pauses, embarrassment overriding everything else, “it’s not like that.”

“It’s not?” She asks, “I think that you’re blind if you think it’s not like that. Dr. Yang is clearly smitten with you.”

He pauses, eyebrows raised in surprise, “Really?”

Addison rolls her eyes and pushes Burke in the direction of the coffee counter, “Just keep walking.”

\--

Adrenaline races through her veins, her heart pounding in her ears and her breathing staggered. Every bone in her body seems to tremble in anticipation and she grasps the side rail of the bed more firmly as she rounds a corner with the surgical team towards the ORs. What she’s doing is truly saving lives, and not just in a trauma situation where she has little time to review the facts and make the ‘right’ decision.

Originally, she was just going to wait for Burke to get into the OR, let him take over as usual but he’s tied up and she’s not waiting for some stupid nurse to put in a history that could destroy the case. She leaves the patient as they wheel into the OR and just before she can make it into the scrub room, Webber blocks her entry.

“I need an update Dr. Yang. And an explanation,” he says, holding up the journal in front of her, “and it had better be a damn good one.”

Cristina balks for a second, tries to figure out exactly how she’s going to explain publishing a journal article with the enemy that she’s supposedly keeping close.

With her job on the line, the STS database to come through this afternoon and a patient that may well try to die on her in the middle of surgery, she does the only thing that feels right.

“Dr. Webber, they just wheeled an emergent patient into the OR. I don’t have time for explanations because I have to do my job. I’ll find you when I’m done,” the words all run together and they don’t sound as forceful as she wants them to but she’s not really used to undermining authority. She pushes through the small space between Webber and the scrub room door and exhales heavily.

Their plan had better work otherwise she just lost her job.

\--

The pencil wiggles slightly and George thinks he may lose it but finally it stabilizes and stays. He reaches for another pencil from the perfectly lined up row and leans back in Burke’s chair to take aim.

“O’Malley, what the hell are you doing?” Burke asks, causing George to jump.

“Nothing, Dr. Burke. I was just waiting to refresh the screen. Again.”

“For the record, I told him to knock it off,” Cristina informs Burke, “but then I kind of hoped that he’d end up with a pencil in his eye and I could at least do surgery.”

“That’s not nice,” Burke chides, handing her a coffee, “it still hasn’t come through?”

“If it had, I would be a surgeon, not a secretary,” George mumbles and then pauses, “Did I say that out loud?”

Cristina glares at him, “Shut up and refresh again. It’s almost five. They have to post it today or we have to wait until Monday and I don’t have until Monday.”

“Why not?”

George doesn’t get an answer but he knows that something is up with the look that Cristina gives Burke. He looks at the time again and the minute hand shifts two minutes closer to five and he shakes his head, “You know it’s not going to show up today.”

“It’s not five,” Cristina says, her eyes fixed on the clock.

“Cristina, it’s not going to show up today,” Burke concedes in a gentle tone. He’s aware of the fact that he knows her better than anybody else in this hospital, but he still doesn’t truly know her and he doesn’t know how she’s going to react.

For a long moment, she’s quiet, making both men nervous. She chews her lip and picks at the recycled sleeve of her coffee cup and they can see the mental gymnastics taking place in her head. When she finally opens her mouth and says something, it’s not really something that either man expected, “We need to get away from the hospital for a weekend.”

“Excuse me?” Burke says, confused.

“You know why. You know what’s wrong. And you,” Cristina says to George, “can stay and cover the patients with Addison. We don’t have any surgeries.”

“What if we get an emergent case?” George asks, “I don’t think it’s a good idea.”

Burke sees the urgency in Cristina’s eyes but he’s wary of the suggestion. Cristina hasn’t shown him any reason that he can’t trust her but he’s still protective of his work. The work that he won’t have if they can’t pull this off. “Get your things,” Burke says quietly to Cristina and she nods and leaves the office.

Once Cristina is gone, Burke walks around the desk to the computer and refreshes the page once more. A list of the STS certified hospitals populates and Seattle Grace isn’t on it. Reluctantly, he moves the cursor to a list of current applicants and their representatives and he scrolls down. He’s never bothered to check for himself. They’ve been doing the work together and he foolishly assumed that the information was submitted.

“There’s nothing there,” Burke says quietly, a swell of anger at himself and her rising in his gut.

“Because you’re looking under ‘Y’,” George answers and pushes his hand out of the way to scroll back up to ‘B’, “she put it under your name.”

The anger fades to embarrassment for doubting her and Burke stands up, “You can let Addison know?”

“If I have to,” George half groans.

“You’re a good man, O’Malley,” Burke assures him and shuts down his laptop. “If there are any emergent cases, you’ll operate with Addison.”

“You know she’s going to be really pissed off at you,” he half argues, “like really pissed. Not just Addison pissed.”

Burke smiles faintly, knowing that she’s not going to like any of it, “I’ll take care of it on Monday.”

“So you and Dr. Yang,” George starts to imply but changes his mind just as quickly when Burke clears his throat and his jaw tenses, “will be back on Monday. Good. I’ll tell Addison. Have a good weekend? I guess. Are you going to be close?”

“I’ll see you on Monday, O’Malley,” his words are definitive and elusive all at the same time.

Once Burke is gone from the office, George lets his head fall against Burke’s desk with a dull thud and mutters something to himself about ruining Addison’s plans again. A pencil falls from the ceiling, hitting him in the back of the head and he sighs.

“I hate my life.”

\--

Addison groans softly at the harsh shrill of her pager cutting through the silence of the on call room. She’s been doing nothing but working and worrying and the only thing she wants is two hours of sleep.

When she sees a simple X on her pager in lieu of a number, code that she’s covering the department, she knows that rest isn’t something that’s going to happen right now.

\--

They ride in silence until they’re about twenty minutes south of the city. Burke can see that Cristina is in deep thought and he’s waited patiently for her to just to say what’s wrong but she’s obviously not going to start talking anytime soon.

“Now that we’re out of Webber’s ear shot are you going to tell me what’s wrong?”

Cristina glances over at him and she can’t help but smirk just slightly at his weak attempt at a joke. There’s something about him, something about the way he’s so incredibly serious all the time that even a joke comes across as a literal statement that she finds intriguing and confusing at the same time that she finds it undeniably attractive. There are other things that she finds attractive too but she is doing her best to chalk it up to professional admiration rather than the alternative.

“Cristina?” he questions, concerned about her lack of an answer.

“He tried to talk to me today.”

“So we’re leaving town?” Burke asks, confused by her reasoning.

“No, he had the article. I can’t say that I’m trying to dig up dirt on you when there’s proof that I’m actually working with you. There’s nothing I can say. So now we’re both going to lose our jobs if that database doesn’t come through. And he can’t fire us if he can’t find us.”

“Technically, he can.”

“Well, it will be a lot harder to do so now. And if we show up on Monday after the database is posted, then it won’t matter,” Cristina elaborates. It’s a sloppy plan but it’s the only one she could come up with, “I’m sorry. I know that Addison will be upset.”

“She’ll be okay,” Burke assures her.

“I’m sure that she doesn’t like us working together anyway. I mean, I know that you guys are whatever but-”

“Wait, we’re whatever? Define whatever.”

Suddenly, Cristina feels foolish pointing out his relationship with Addison, “You know.”

“I’m afraid that I don’t,” he says, immensely enjoying Cristina’s embarrassment.

Cristina casts another sideways glance in his direction, “Well she obviously hates me for a reason. She has a right to. This project has been encroaching a lot on your time and I’m sure that it has interrupted a lot of your plans and that it looks like we’re- I mean, I know we’ve been working a lot and I’m sure it looks like something else,” she starts rambling, “not that it is. And I’m not going to tell her otherwise because then it looks like we’re trying to hide something and there’s nothing to hide. It’s not that. But I could see how she would think that.”

She knows that she’s talked herself into a corner and she doesn’t know what she’s supposed to say to get out of it so she simply stops talking all together.

“If you’re insinuating that I’m in a relationship with Addison, I hate to disappoint you but I’m not,” he says.

“You’re not?” Her voice is less surprised and more curious than she would prefer.

“Does that disappoint you?” Burke asks, his voice just as curious as hers.

Cristina keeps her eyes fixed on the road and smiles to herself, “I don’t even know where the hell we’re going.”

“That makes two of us,” he says, disappointed that she didn’t really answer his question. He’s not sure that it would actually ever go anywhere between the two of them, there’s too much else to think about right now and getting involved has too much potential for becoming messy.

Not that everything else in his life isn’t messy right now.

“Portland is 72 miles away,” Burke says idly as they pass a sign, “or we could take the next exit for Toledo.”

“Toledo is a city in Ohio,” Cristina scoffs, glad that they’ve left behind the awkward topic of conversation.

“Congratulations, Dr. Yang, you know your geography,” he teases her in a flat voice.

“Alright, Preston,” she says, emphasizing his name, “you’re not helping.”

“I wasn’t aware that you were in need of my assistance.”

“Where are we going?”

“Where do you want to go?”

“I will pull this car over,” she threatens idly.

“Or you could just keep going to Portland. One day we’ll be able to tell a story about how we ran to a different state to avoid the wrath of Richard Webber,” he says, slightly amused at his unique sense of humor. He’s hopeful that one day he’ll be able to share his joke with the Chief of Surgery as friends as he’s seen Webber interact with his colleagues.

“Portland it is,” Cristina says, “I didn’t want to end up in some cheap no-name hotel in Toledo with a greasy pizza and a bed with magic fingers anyway.”

\--

Cristina plucks the cherry tomatoes from her salad and hands them over to Burke. He takes it in exchange for the olives off his pizza which she subsequently dumps into her salad and then continues, “So the grading system for high risk patients. We should probably give it some sort of name.”

“It has a name. It’s the Burke scale,” he says, knowing that she’ll never go with it.

“Not going to happen. It can be the Yang scale.”

“We could do that thing where they combine syllables to make a new name,” Burke suggests with a cheesy grin.

“Apparently you failed English. We only have one syllable last names.” Her voice is slow and patronizing and it earns a mock look of offense from him.

“So we combine sounds.”

“Yurke sounds like vomit and Bang sounds dirty. It’s not happening,” she says, “We’ll just call it the…I don’t know. It’s the scale for grading high risk cardiothoracic surgery patients.”

Burke shakes his head, looking over the papers, “I still can’t believe we have this scale,” he admits, “I’ve been so focused on just doing it that I never thought to use the system to beat the system.”

“You just needed me,” Cristina grins, “besides, forming a group of rogue surgeons, while influencing lives, wouldn’t change anything. Not that I’m saying what you were doing was bad. It was just a slightly flawed plan.”

“I’m not going to argue with that, but I’ll argue with it.”

“It’s fine. You can keep your rogue surgeons. I’ll publish the scale and change the world,” she taunts, “it will be perfect. For me.”

“Oh, I think not,” he chuckles and flips through the papers. There’s so much there besides a scale: complications to expect dependent upon the patient’s grade, interventions for those complications to minimize the impact of the complications and improve patient outcomes. He can’t stop looking through the papers. It’s everything he’s ever worked for put into a language that the field can appreciate.

“What was your dad’s name?”

Burke looks up at her from his spot on the floor, “Donald. Why?”

Cristina wrinkles her nose slightly, trying not to be offensive while rejecting that idea, “What about his middle name?”

“Why?”

“Just answer me,” she says, “it’s not a difficult question.”

“Fine, it was James. Why?” he repeats for the third time and hopes this time for an answer.

“The James Scale,” Cristina suggests passively, “It’s not like we’re going to agree on putting just one name on it and both of our names on it kills how awesome it is. We need something pithy. It works.”

Her explanation masks any sign of actually being sensitive or caring because Cristina simply can’t suggest that the work was all because of his dad anyway. That the name is appropriate for that reason alone.

That doesn’t mean that Burke doesn’t get it anyway.

“The James Scale,” he repeats, playing with the words. He knows it’s right and it feels like he’ll finally be able to close that chapter of his life. Burke uses a napkin to wipe his fingers before he gingerly picks up the papers from in front of him and proceeds to tuck them back in their folder. He pulls the papers off the bed in front of her and does the same with them.

“Wait, whoa. What are you doing? We have a ton of work to do.”

Burke sets the papers on the bedside stand before he turns back to look up at her again, “I have worked ever since I started med school. Every day. I put more hours in, accepted more special projects, read more articles, and did more research than everybody else. I have done nothing but work.”

“All work and no play makes Burke a dull boy,” Cristina jokes, and then adds in a softer voice with her eyes lingering on his, “and a kickass surgeon.”

Their gazes remain fixed and Cristina contemplates admitting that she wasn’t disappointed to hear that Addison isn’t a thing but she doesn’t have to do it because he figures it out on his own.

The bed shifts slightly beneath her as he leans against the edge, brushes his lips gently against hers. He pulls back for a split second to gauge her reaction and assumes that it’s a positive one when she leans forward and kisses him again. Her fingers slide up his forearm and along the pronounced curve of his bicep to his shoulder and she pulls, urging him off the floor and onto the bed with her.

Burke eases her back as he joins her, moves so that his body is half over hers and they both know where it’s going but neither care to stop. His hand brushes against the skin exposed just above the waist of her jeans and his fingers inch underneath the fabric, timid about traveling any further.

Cristina reaches down and breaks the kiss long enough to discard her shirt, “Better?”

He takes a moment to appreciate the purple lace bra barely covering her breasts and he nods, maybe a little too emphatically, “Much.”

“Good,” she answers, fingernails scraping his lower back as she tugs at his shirt. He pulls it up and off, tossing it to the side and it’s Cristina’s turn to stare. Her hands start at his abdomen and she slides upwards, her light touch causing him to shiver. She’s imagined a lot of things about him, most of them surgical in nature, but outside of kissing him she’d never imagined this.

Burke unbuttons her jeans with one hand which is as impressive as much as it is a turn on. His fingers slip beneath the waistband and she holds her breath in anticipation and then lets it out slowly when he tugs her jeans down her hips. Once they’re gone he hovers over her, fully taking her in, “You’re beautiful,” he utters, his hand caressing her hip.

Cristina can feel her face get warm and as much as she wants to look away, she can’t. Instead she leans up on her elbows and kisses him again, hoping that he’ll just shut up and keep going because as far as she’s concerned, there’s still way too much clothing in this equation.

Limbs tangle as he drags his fingers across her thighs and she tries to get rid of his jeans. He finally relents for just a second until she can get them and his boxers halfway down his legs and it’s really all she needs. He groans when she brushes her hand against him, wraps her fingers around his length.

Painful though it may be, Burke pulls her hand away and pins it to the bed. His lips move down her neck and he nips the sensitive flesh there. His hand is between her legs and her hips are grinding desperately against him. He’s enjoying the feeling of her physically begging for more beneath him more than he should. When she murmurs his name breathlessly, he loses any sense of control that he had.

He strips her of her panties, abandoning the hand that thankfully remains draped above her head, and runs his fingers along her folds. She’s already wet and it’s a struggle not to simply push into her but he wants to take his time with her.

There’s no guarantee this will happen again and it’s been a while for him and most likely her too.

This sexy little whimper escapes her lips when he dips a finger inside her, quickly followed by a second. It’s things that he never imagined that make the reality _so much better_ , the fancy underwear that she wears for no reason at all, the whimper, the way she’s murmuring his name pleadingly and the way she’s digging her fingernails into his flesh.

She’s already tight but when he rubs her clit with the pad of his thumb, traces around it torturously she contracts even more, and she’s lost to orgasm. He hisses her name and he can’t hold back any longer. Burke grasps her hips and shifts her body into his, eases against her, into her and she’s pure bliss.

Cristina pulls her hips back slightly at first; he’s big and she’s, well, not big. He eases her into it though, goes slowly until she’s stretching and giving around him and he feels _amazing_. What they’re doing is a little bit slower than the pace that she normally prefers and she thinks that if it’s not incredibly awkward afterward, they may have to do it again just so she can have him her way.

Their hips rock together, skin slick with sweat though the room was freezing cold not that long ago. They continue kissing and the delicate and tentative kisses that they shared at first have deteriorated into something less hesitant and more passionate. He drags his lips downward, over her chest, to her breast and he laves her nipple roughly with his tongue.

Easily blaming it on the amount of time it’s been since she had sex, Cristina finds herself teetering dangerously close to another orgasm and she slips her hands between them to rub her swollen clit. Just as quickly, he pushes her hand out of the way for a second time and lifts his head momentarily to look at her, “I don’t think so,” he says in a near growl and she wants to come up with some sort of feministic reply but she can’t because he’s rubbing her mercilessly and he’s pushing into her harder, teasing her nipple with his mouth and teeth and she _can’t_.

Cristina loses herself beneath him, fingers holding onto his shoulders for dear life and she’s vaguely aware of him spasming inside her, groaning against her flesh. Her hands slip from his shoulders to his hips and she holds him inside her, just enjoying the way it feels, enjoying _him_.

Their lips meet again and the kiss isn’t ravenous, or overly passionate, but comfortable, like they’ve done it a million times. There are feelings behind the kiss but no time to address them.

There’s still work to do.

\--

The rumpled sheet barely covers her breasts and though he knows he should be working, Burke can’t help but watch the rise and fall of her chest, completely enchanted with her form. The point of this weekend was working, not this.

“You’re staring.”

“In medicine, we call it observing,” he answers with a smug grin, eyes tracing upwards to meet hers, “and I can’t help that you’re a distraction.”

“I can,” she answers simply, pulling the sheet up, “we need a plan to deal with Webber. Just in case the database doesn’t come through on Monday. Waiting any longer isn’t an option and we’re probably going to get an earful for this stunt anyway.”

Disappointed about his now obscured view, Burke’s mind returns to the task at hand, “Then I’ll tell him the truth.”

“Clearly your brain cells haven’t started functioning yet.”

His fingers tangle through her curls and his brain is doing the complete opposite of resting now, “No, they are. We have the article. We have the proposition for the scale. The only way that we’re going to win Webber over with this is if we speak his language. We have to make him see things our way.”

“That’s not going to work. Not without the database. We have to be able to prove that we can get high level recognition with what we’re doing. The database proves that your patient outcomes, while not desirable to the norm, is still something to be recognized by a national organization. It backs it all up,” Cristina argues, “you can’t tell him yet.”

“The database will come through and Webber can’t do anything immediately anyway,” he contends, shifting to his side so he can better look at her, “he’ll have time to think about it, the database will come through and back it up and we will have come clean without the evidence. It will work.”

Cristina looks up at him, shaking her head. She knows how dangerously close they are to losing their jobs if they haven’t already lost him, “Burke,” she mumbles, “just-”

“Trust me.”

“I do, but-”

“‘But’ does not involve trusting me. Just trust me. You don’t have to say anything, you don’t even have to go in there with me. I’ll handle it.”

“If you think I’m letting you take all the credit, you’re crazy. We’re in this together. You may have started it, but I’m in it now. I’ll be in there,” she promises, “this is our thing now.”

Burke’s affected by her words in more than one way and he leans over, kisses her again. The thought crosses his mind that he could get used to this- that he _wants_ to get used to it if they can just make it through the next few days.

“We’re supposed to be working,” she murmurs into his mouth.

With relative ease, he lifts her on top of him, “We’re taking a break.”

She murmurs his name in a halfhearted protest but he silences it with another kiss. They both know there’s no more work to do. Talking about work keeps them from talking about the obvious though and for the moment, it needs to remain that way.

\--

There’s a sharp pain in Addison’s side and she jumps, “What the hell was that for?”

“Look who decided to finally come back,” George mumbles into her ear, trying to be obscure despite the fact that he’s anything but, “what do you think they did all weekend long?”

“I’d rather not think about that. I have work to do,” she says, closing a chart definitively, “and it’s none of your business either. Just pay attention to the patients.”

“Addison,” Burke greets, Cristina still at his side.

She glances at the two of them and then lifts her chart from the counter without another word. She walks away and knows fully that Burke will follow her. Burke and Cristina share a glance and Cristina hangs back while Burke walks ahead to catch up with her, “You’re angry with me?”

“Did you enjoy your little weekend off while we were here trying to cover your ass?” She asks, making no effort to be even a little bit quiet.

“We were working.”

“Right,” she says slowly, “you were working.”

“Addison,” he sighs. He’s been privy to these moods before and he knows how difficult it is to console her when she’s this angry.

Burke also knows that the anger is well deserved.

“Don’t. Do not make me feel guilty for being angry with you. This was us. You, me, George- the three of us were in this together and then you drag her into it or she put herself in it and suddenly, you just abandon us, so what? You can get laid, Preston? Is that what this is?” She asks, “Because if you gave a damn about the department anymore, maybe you’d pull yourself away from Dr. Yang long enough to see that you’re being careless.”

Addison’s words surprise Burke and he can see that she’s hurt, “I’m sorry.”

“I’m not listening to you apologize. It’s a waste of my time and it’s a waste of our patients' time. You’re losing your focus and she’s to blame for it. I don’t know how you can’t see that.”

“Addison,” he says again, losing count of how many times he’s tried to explain himself, “I’m going to Webber.”

“You’re _what_? Is this her genius idea? Turn yourself in and he’ll be totally fine with it? I can’t believe you’re listening to her Preston. You have got to see through her motives,” Addison says, glaring past him to Cristina, “she’s got you right where she wants you and you’re just going along with it.”

“Actually,” he interrupts, moving to obstruct Addison’s view of Cristina, “it was my idea.”

Addison falls quiet and her gaze shifts to the floor, “You’re being careless.”

“I’m making this right,” he says in a low voice, “I can leave you and O’Malley out of this, if you prefer. It’s up to the two of you. I’ll accept all responsibility but what Cristina and I have worked out, the research and the database, it’s your work too.”

“You’re saying what?”

“I’m telling Webber the truth, the records, the patients, the referrals, all of it. It’s up to you if you want to be a part of that. It’s your work but if you’re concerned about your career, I’ll understand. I’ll shoulder the blame and whatever consequences come with it.”

She chews on her bottom lip for a minute, trying to contemplate his so called consequences. There’s no way she’s letting go of all of that work but she’s not going to let that on so easily, “I want to know exactly what you two have been plotting. All of it. And I want to know why you’ve kept it from me.”

\--

The office door seems heavier than normal when Cristina pushes it open. The room is smaller, he’s bigger and everything is more daunting. Especially with what they’re about to do. Webber looks at her, an expression of displeasure already clearly painted across his face.

When Burke follows her inside, the look of displeasure turns to something much more frightening.

“Close the door,” he says through gritted teeth, immediately putting his pen down.

Burke does as asked and they both take a seat in front of his desk. The glance Webber aims at Cristina does not go unnoticed by Burke and he smiles inwardly at the way she doesn’t shrink away from it. She does a good job of hiding her emotions.

Almost too good of a job.

“Dr. Webber, I requested to join Dr. Yang in this meeting,” Burke says, disrupting Webbers silent admonishment.

“Is that so, Dr. Burke? And you’re aware of what this meeting is about?”

Cristina answers before Burke can, “He does.”

“I hope you’re aware of what this means, Dr. Yang,” Webber says, “and Dr. Burke, you can expect the same treatment for your blatant disregard of this hospital and the hospital’s goals and missions.”

“Actually, sir, that’s why we’ve come here today. I want to speak to you about the hospital’s goals and missions and how my department not only meets those expectations but exceeds them,” Burke says evenly, extending a heavy folder to Webber.

“Your department is a disappointment and nothing but,” Webber spouts, ignoring the folder.

“With all due respect sir, look at the folder,” Cristina chimes in, “what Dr. Burke is doing is groundbreaking stuff. It would put Seattle Grace at the forefront of cardiothoracic medicine if you hear him out. Take the folder.”

“And what exactly is Dr. Burke doing?” Webber is doing his best not to satisfy his curiosity as to the folder’s contents, especially without an explanation as to what’s going on. “Please, explain yourself.”

Burke inhales deeply, steels himself to Webber’s judgment. What he’s doing is right and what they’re doing is going to work. That’s the only acceptable outcome, “With the assistance of few, I have been performing surgery on non-operative candidates. Renal failure, long term uncontrolled or poorly controlled diabetics, peripheral vascular disease, amongst others. The short term complications are apparent as you well know, but the long term outcomes are desirable.”

“You’ve been _what_?” Webber asks incredulously, “Your medical records reflect nothing of the sort.”

“The reports are inaccurate,” Burke says, “due to the fact that I knew it would interfere with my ability to help these patients. I have the accurate medical records stored in a safe place and their privacy has been maintained.”

Cristina flinches when Webber tells the two of them to get out but neither one of them move. She can see the vein on the side of his head pulsing with his heart rate- about 110 right now- and she knows they’re pushing their luck, “Sir, please just look at the folder.”

“What’s in the goddamn folder?” Webber finally asks, taking the folder and dropping it on his desk without opening it.

“A grading scale for high risk patients. It lists the complications to expect when dealing with the patients, management of, risk associated with surgery. It’s simply waiting to be published,” Cristina explains, “we’re also pending accreditation from the Society of Thoracic Surgeons to back up what we’re doing. They have full knowledge of the patient outcomes, both long and short term. The accreditation should come through any day now.”

“If it comes through,” Webber counters.

“It will come through,” Burke interrupts, “this work could make a difference in the lives of thousands, Richard and Seattle Grace will be the pioneer. It’s the publicity you want, the work I want, without obsessing over frivolous numbers.”

“Those so called frivolous numbers are what keep us at the top of the field.”

“And this changes the field,” Cristina points out, “in a major way.”

“You’ve put the hospital at risk!” Webber roars, standing up, “You’ve put our accreditation at risk with CMS, you’ve put your careers and medical licenses at risk. What you’ve done is dishonest, dangerous and irresponsible. What you’ve done is-”

“Groundbreaking,” Burke answers calmly, “and right. It’s the right thing to do.”

“You could have lost our funding.”

“The funding that my patients funnel into the hospital is more than enough. What I’m doing isn’t going to lose accreditation as long as the hospital backs me. It will only raise eyebrows from the more conservative surgeons.”

Cristina reaches forward to nudge the folder towards Webber, “Just look at the information before you do anything.”

Webber looks down at the file and then at her, “Was this your intention all along, Dr. Yang? Mislead me until you could help Dr. Burke?”

She shakes her head, looking away from Burke. She still feels guilty for the pretenses under which she was hired, “No, sir. At first, I-”

“I dissuaded her from her original assignment,” Burke interrupts, without so much as looking at Cristina, “nurses overheard a conversation and alerted me to what was going on. Dr. Yang was doing her job and I dragged her into it.”

Cristina looks at Burke for only a moment, angry and awestruck all at the same time. She turns her attention back to Webber to offer her side of the story but he speaks again.

“You’re both suspended. You so much as set foot in an OR and I’ll see to it that you’re fired immediately,” Webber says, sitting down.

“What?” Cristina asks, looking at him with raised eyebrows, “We’re not fired?”

“Do you want to be?”

“No,” Cristina answers immediately, “no, I just…if we’re not operating who’s going to-”

“Dr. Montgomery will be covering for both of you,” he mutters and then adds, “on stable patients only. None of this crap. Am I understood?”

“If a patient comes in-” Burke starts and then stops, “we don’t have to declare them inoperable immediately. We can wait until we hear from you?”

Webber clenches his jaw and rather than answering gives the slightest of nods. It’s not exactly something that he likes the idea of agreeing to but he’s also intrigued- and slightly proud- of the presentation that his two surgeons have put together. Anything that puts Seattle Grace on the map is at least worth hearing out.

He’s hoping it’s also worth the headache that he’s going to get when he goes before the board to explain the delay in the investigation.

Again.

“Thank you sir,” Cristina says, “thank you. You won’t regret this.”

“Get the hell out of my office.”

Without another word, the two immediately stand and walk outside, fighting back smiles until they’re in the hallway. They’re not relieved by any means, but they’re also not fired which is cause for celebration enough.

\--

Cristina leans back against the wall and sighs. So many things could have gone wrong today but they didn’t. She’s thankful for it but she’s still uneasy, no matter how much Burke had told her to relax. She doesn’t understand how he can seem so calm right now. This is his work, mostly. She should be the one telling him to relax.

“You realize that you’re supposed to be looking out the window, right? That’s the purpose of an observation gallery.” Burke walks over to Cristina and pauses to watch Addison down in the OR for a moment before taking a seat next to Cristina on the floor, “Are you okay?”

“I should be asking you that,” she says softly.

“I’m hopeful,” he says, looking over at her. He resists the urge to reach out and tip her chin up, to kiss her and soothe her in a different way. Their weekend shared together was an even mix of work and the other stuff, the latter leaving him only wanting more rather than being able to focus completely on work. Despite that fact, they haven’t discussed it and now isn’t a good time to bring it up.

“Be hopeful for both of us.” It’s her way of admitting that she’s scared, nervous, whatever feeling it is that she rarely ever acknowledges. She glances over at Burke and sees the look in his eyes and she falters slightly, remembering their weekend as well.

“You realize that you don’t have to keep this up?” He says, “You can go back to winning your awards and your perfect numbers. You don’t have to do this.”

“What? And give up working with you?” Cristina smiles faintly, “No award is worth that. Besides, there’s no way I’m letting you outdo me with some stupid high risk scale.”

Burke’s smile mirrors her own and he stretches his arm out to slip it around her shoulder and pull her close. His lips brush her forehead when she settles against him, “Good.”

\--

The messy black curls are unmistakably _hers_ and Addison doesn’t even hesitate for a moment before taking a seat next to the woman. She orders a glass of white wine from Joe and looks over at Cristina picking at a peanut shell, “Where’s Preston?”

Cristina’s surprise finally fades from Addison sitting next to her and she shrugs, “At home trying to get some sleep. I don’t think either one of us have slept for at least a month.”

“Then why aren’t you at home sleeping?” Addison cares less about whether or not Cristina is getting any sleep and more about what she’s doing at the bar while Burke is at home sleeping. She doesn’t like Cristina but she’ll like her even less if she does anything to hurt her friend.

“Couldn’t sleep,” Cristina mumbles, reaching for her drink.

“You know,” Addison starts, “Preston is a good guy. He’s a great guy, even. Very focused on his work, always wanting to do the right thing, even to his detriment. I care about him a lot, what he’s doing for people.”

“I know. That’s why I’m trying to help him,” she looks over at Addison, “I know that you don’t like me and that’s fine. You don’t have to. But I care about what he’s doing too.” She leaves out the part where she cares about Burke because that’s not really any of Addison’s business and Addison definitely doesn’t have a right to know before she actually says it out loud to him.

If she can ever work up to that.

“I don’t like you,” Addison agrees, “but Preston does. You’ve…you’ve brought out another side of him. He’s always been focused on his work, maybe too much. He’s never joked, smiled rarely. And now he does. He seems happy.”

Cristina doesn’t have a response for what Addison has said. She was the same prior to meeting Burke, prior to really getting to know him and she thinks, no, she _knows_ that it means something.

“I thought you were bad for him, for the department. And I was wrong,” It’s the closest that Addison will ever get to an apology to the other woman. The two of them still went about things the wrong way, they still hid things from her and she’ll take a while to get over that, but what Cristina did for him was unexpected.

A faint smile traces Cristina’s lips. It’s a blessing of sorts for whenever their thing can become a priority, “Thanks.”

“You have feelings for him,” Addison says, less of a question and more of an observation that’s been in desperate need of acknowledgement. Not because she doesn’t already recognize it but because she needs to know that Cristina is willing to verbalize reciprocation for what she knows Preston obviously feels.

Tracing her fingers around the top of her glass, Cristina considers the woman’s words for a moment and then looks over at Addison, “I wouldn’t want to work with anybody else.”

\--

Webber paces back and forth behind his desk, hands clasped firmly behind his back. The room is stiflingly silent as Burke and Cristina look on, watching as Webber passes like a caged animal. By the time he finally speaks, they’re sufficiently uncomfortable.

“Do you realize the position you’ve put me in?” He asks, and his voice is a lot more threatening than either one of them could have possibly imagined, “What you’ve done to the hospital? This Robin Hood act has done nothing but make me very angry and put me under a lot of stress. The last thing you want to do is piss off the Chief of Surgery, the Medical Review Board, and the Chief of Staff. I would think that you’d both know that.”

They agree in unison but are afraid to even apologize afterwards.

“I should report you,” Webber continues, “have your licenses revoked. You know the legalities of the situation, the compromise that you placed on your career and yet you did it anyway-”

“Dr. Webber,” Burke starts to contend, now sufficiently certain that he’s going to lose his job and possibly his license.

“Because you wanted to do the right thing,” Webber finishes, sitting in his chair, “you nearly lost your jobs. I was preparing to go to the review board with your termination papers when Patricia brought this to me,” he extends a letter to Burke.

“What is this?” Burke asks, looking down at the letter.

“It’s notification from the Society of Thoracic Surgeons recognizing your advances in Cardiothoracic Medicine and certifying your department as a center for cardiothoracic surgical studies. I showed it to the board, along with your scale and your…transgressions.”

“And?”

Webber looks intently at Burke, “You’re suspended from the OR for six months. You may oversee the department and cases, continue your research so long as it doesn’t involve a scalpel in your hands. Dr. Yang and Dr. Montgomery will operate on patients, including the high risk ones. All medical records will be reviewed by a third party for tampering and we will require a copy of all medical records from outside facilities and referrals to come through my office prior to surgery being scheduled. Any sign that you’re putting this hospital at compromise, Dr. Burke, and you’ll be out of a job and a license to practice medicine. Do I make myself clear?”

Burke can’t fight back a wide grin. It’s the validation that his work has needed, “Yes, Dr. Webber.”

Cristina blinks, still in disbelief, “You mean we’re not fired?”

“Do you want to be?” Webber asks, this time amused by the seemingly steely surgeon’s reaction.

“No, sir. Not at all,” she answers quickly and then adds, “thank you.”

“Don’t thank me. I want you to do your jobs. If the budget falls out of the green or you start killing patients more than you save them, I’ll cut you both off.” Webber watches as they fumble over themselves to express their understanding and shakes his head, “Get the hell out of my office. Now.”

The two leave his office immediately, not taking time to ask any more questions. Pushing for anything else right now would be foolish and they know that. They share a suppressed celebration a few feet outside Webber’s office, relieved that everything seemed to work out with such minimal consequences.

\--

George’s head tilts to the side in confusion, “Seriously?”

“Would I lie about this O’Malley?” Burke asks, the slightest smile still turning up the corner of his lips.

“I still don’t believe it,” Addison admits, “it doesn’t seem real.”

“It’s real,” Cristina finally chimes in though she still feels out of place. Though she had a hand in developing the scale, a hand in working with Burke for the past few months, she’s still very much the outsider.

Addison looks at Cristina, slightly unhappy about the fact that she has to answer to the other woman for the next six months on all things surgical but it’s a small price to pay for Preston’s work being validated.

It’s an even smaller price to pay to keep their careers intact.

“So, should we celebrate or something?” George suggests, “We could all go get a drink at Joe’s.”

“Actually, there’s a patient in the ER,” Burke answers hesitantly.

Cristina sees the look of disappointment mixed with exhaustion on Addison’s face and glances at Burke apologetically, “I’ll take care of it. They’ve been here all weekend long. They need a break.”

There’s surprise in Addison’s eyes but it fades quickly, “You just want to show off.”

A slight grin crosses Cristina’s lips, “You’ll never know either way.”

Burke looks between the two women and senses that they may butt heads more than once over the next few months. It amuses him when the thought crosses his mind that it may have been easier to deal with covering up his patient’s histories than dealing with two stubborn women.

\--

“You’re sure that Webber is okay with you scrubbing in?” Cristina asks again, looking over at Burke, “I’m not accepting responsibility for you going against his orders.”

“He said I couldn’t hold a scalpel. A suction catheter is totally different,” he grins beneath his surgical mask and then adds, “and yes, he said it was fine, especially after I told him that O’Malley and Addison were over hours. You worry too much.”

“Do not,” she answers haughtily before backing into the OR.

Burke is still grinning beneath his mask when he follows her into the OR and watches as she gowns up. They’re celebrating tonight, as soon as they get out of surgery. What they’ve set out to do is done and he has a hundred things to say to her.

None of them pertain to work.

Cristina makes the initial incision and Burke feels a twinge of jealousy that he’s not able to operate for six months. It’s a long time spent out of the OR but he tries to remind himself that it’s worth it. When Cristina opens the chest cavity and reveals the patient’s heart, the jealousy changes to pride as she immediately gets to work. Her hands are delicate as she works, following almost every piece of advice that he’s ever given her when it comes to working with these complicated patients.

Despite his instruction, however, she still uses a bit of her own technique too. She pauses to point out that her technique would be more appropriate in this situation and he’s too busy being amused to actually listen or agree with what she’s saying.

It’s still surreal to him that they’re doing this and the Chief of Surgery is aware of it.

Once her work is done and they begin rewarming the heart, his hand brushes hers at the base of the chest cavity and their eyes meet. There’s suggestion lingering between the two of them and she clears her throat but doesn’t even bother to tear her eyes away from his.

She has no reason to for at least the next ten minutes.

The surgery ends without incident and their patient is wheeled out of the OR by anesthesia and the heart nurse. They discard their surgical garb but linger in the OR, leaning against the table. “Beat your best time,” she teases him gently.

“Oh, is this a competition?” He asks, “I wasn’t aware.”

“It’s always a competition with me. You should know that.”

Burke crosses his arms, taking in the information, “Is there anything else I should know?”

“I take my coffee black, I prefer my Chinese food from Shanghai Garden, locally brewed beers are the best, and I’m off this weekend. But I think you already knew that one,” she rattles off, never taking her eyes off of him.

“I did know that one,” he confirms, placing one hand on either side of her against the OR table, “and I intend on taking full advantage of it.”

“You should,” Cristina slips her arms around his waist and pulls him closer to her, “as a matter of fact, I insist.”

Burke smiles before he kisses her and holds her body tightly against his. She responds, matching the fervor of his kiss before pulling back with a small smile.

“You know it’s a bad idea to fall for your colleagues.”

“I think it’s far too late for that,” he mumbles in a low voice, fingertip tracing against the small of her back.

Cristina smiles faintly and kisses him briefly once more, “Yeah. I know.”

\--

There’s a quiet intensity about him as Burke stands before the roomful of his colleagues, alongside the woman he loves. The moment is surreal, accepting the Harper Avery award for his advances in cardiothoracic surgery. His speech is short and it centers on the patients affected by his work rather than his work itself. After a brief thanks to the people who matter most to him, he steps aside and the room applauds.

Not so long ago, many referred to Preston Burke as a great disappointment to cardiothoracic surgery. The board questioned his lackluster numbers and the Chief of Surgery questioned his competency as a surgeon. He was falsifying medical records just to give his patients a chance at living.

Though his methods are not widely accepted, there have been several articles in response to his two, the fact remains that there are some who accept them. There are surgeons who have reached out to him for further education on how to manage the patients beyond the scale, surgeons who respect and want to learn his surgical techniques.

Just as before, the award in his hand still isn’t of importance to him.

While the recognition is nice, the acceptance of his work is better. He’s learned though that there’s more to his life than his work, that the people who have been at his side are what matter the most.

He’s not the only one who has learned that lesson.

Cristina’s fingers are loosely laced with his, obscured between their bodies as he examines the award. She reaches out to take it but he pulls it away teasingly and then steals a quick kiss, a rare public display of affection. Addison fakes a gag and pulls the award away from both of them to look at it for herself.

“It’s not that impressive,” Addison mutters.

“Tell that to Shepherd,” George smirks, nodding in the direction of the man stewing in the corner.

Addison glances towards Derek sitting in the corner and then back to her dear friend, “Actually, I’m going to borrow this for a moment if you’ll excuse me.”

Cristina watches as Addison walks away from them with the award that wasn’t ‘that impressive’ only fifteen seconds ago and then shifts her gaze to George in curiosity, “What is that all about?”

“Cocky neurosurgeon ex-boyfriend,” he explains and curses a moment later when the sauce from his hors d’oeuvre drips onto his tie. He walks away, muttering to himself and dabbing at the tie with a rumpled napkin, leaving Burke and Cristina alone.

Burke surveys the room, taking it all in one final time. The attention has been exhausting but well worth it.

Her fingers tighten around his slightly, “What are you thinking about?”

“I’m thinking that while it’s been a nice evening, I am sufficiently ready to go home,” he answers, turning his gaze to hers.

She smiles faintly, “You actually think you’re going to be able to pry that award out of Addison’s hand anytime soon? It seems as if she’s enjoying it despite the fact that it’s not that impressive.”

“It’s not ours to take home yet. Richard wants to place it on display in the lobby for a while.”

Cristina frowns slightly. She knows that the Harper Avery isn’t a big deal to him but she’s proud of the fact that she’s finally got one under her belt, though she really only did the data analysis and compilation.

The next Harper Avery will be hers and hers alone.

“He had better give it back,” she mumbles begrudgingly.

“If I didn’t know any better, Dr. Yang, I’d say that you were rather taken with that thing. Perhaps I should leave the two of you alone.”

“Fine. You can do that,” she answers, though she means anything but. While she came to Seattle Grace for the awards and the recognition, what she’s got now with Burke isn’t something that she would give up so easily.

Burke brushes her hair from her shoulder, leans in so that only she can hear him, “I’d rather take you home.” His voice is low and tone suggestive of how he’d rather be celebrating their achievements.

“You don’t think they’ll miss us?” she asks weakly though she doesn’t give a damn about any of them. She’s more than happy to shed her heels and dress in lieu of something more comfortable, or preferably, nothing at all.

“I don’t care if they do,” he responds, slipping his arm around her waist and guiding her from the room. Burke has spent the better part of his life working to make sure his patients had a chance to live their lives and now that he’s succeeded, he is looking forward to living his.


End file.
